Objective: Deep neck infections (DNI) may present a complex clinical picture depending on etiological factors and comorbidities. The effects of these predisposing factors on biomarkers – systemic inflammatory response index, pan-immune-inflammation value, neutrophil-to-lymphocyte-to-platelet ratio, C-reactive protein–albumin–lymphocyte index (CALLY index), and hemoglobin–albumin–lymphocyte and platelet score (HALP score) – and their relationship with the disease course were evaluated.
Materials and
Methods: This retrospective cohort study evaluated patients hospitalized with DNI. Demographic, clinical, and laboratory data were recorded and biomarker values calculated. Patients were grouped by infection source and comorbidities into Group A (fewer than two risk factors) and Group B (two or more). They were also classified by treatment as medical (Group 1) or surgical drainage (Group 2). Biomarkers and laboratory parameters were compared between groups, and their association with disease course was assessed.

Results: Among 82 patients, demographic features and treatment distribution were similar across groups. Group 2 (surgical drainage) had longer hospital stays (p=0.003) and lower hemoglobin (p=0.013) than Group 1. Lymphocyte counts were lower in Group B and higher in Group 2 (p=0.023, p=0.050). Group B showed reduced CALLY index and HALP score (p≤0.001), while other biomarkers were comparable. CALLY index had high sensitivity (94.9%), and HALP score showed high specificity (74.4%).

Conclusion: The coexistence of infectious sources and systemic comorbidities significantly affects the clinical trajectory and therapeutic strategies in DNI. Accordingly, biomarkers such as the CALLY index and HALP score serve as valuable tools for predicting their influence on disease progression.