Collection in the right side of neck deep to the sternocliedomastoid muscle

[singh_ab]

Please Help - I developed an Inflamation on the right side of neck right after playing cricket . Initially i thought it was a msucle pull and would go away on its own but it did not . I consulted an ENT surgeon to get it checked and he suggested that i get a Sonograpgy done . The report of the Sonography is -
Technique - Ultrasonography of the neck was done using a high frequency Linear Transducer .
Observation -
There is a collection seen in the right side of the neck .
This lies deep to the Sternocliedomastoid Muscle .
This collection Measures 3.5 x 2.3 x 3.5 Cm
It is thick walled and Show Multiple Internal Echoes.
The right IJV is Mildly Compressed in the region of this collection .
The right Carotid Vessels are Normal
The Thyroid Gland Shows Normal Appearances .
Several Lymph nodes are seen in the right side of the neck . These are subcentimeter in Diameter .
Impression :
Collection in the right side of neck deep to the sternocliedomastoid muscle . Differential Diagnostic Possibilities would Include -
1.) Resolving Hematoma.
2.) Abscess
Advice - Aspiration and Further Management .
After the Sonography Results i was given medication which included
1. Augmentin 625 MG (2 Times a Day )
2. Enzoflam (2 times a Day )
3. chymoral Forte (3 Times a day )
4. Roles D (Once a day )
I continued with these medicines for about one and a half week and after that the swelling started subsiding . All of a sudden due to physical activity (dancing ) it increased again and now the doctor says that i should get aspiration done .
What should i do , what specialist should i consult ? is it serious ? Are my Lymph nodes normal?

[Sumer K Sethi, MD]

In your case, probably the history of trauma is not so relevant or amy be it is, as there is cololection deep to the sternocleidomastoid. It can be an infection or a resolving bleed as has been correctly described. You have improved on antiobiotics also indciates an infective process but it has agiann  regressed. Yes it needsa spiration but before that i would want that we do a MRI cervical spine or neck especially to look for the underlkying spine as some times even TB spine can lead to cold abscess formation deep to the sternocleidomastoid.
Aspiration and its laboratory examination will also give us important clues to the diagnosis.