Deep neck abscesses secondary to methylphenidate (Ritalin) abuse

Methylphenidate (Ritalin) abuse has been and continues to be a major medical and social problem. In the past 6 months, we have seen five deep neck abscesses secondary to intravenous Ritalin abuse. This constitutes more than 50% of the deep neck abscesses seen by us in the same time period. The pathogenesis is related to an inflammatory foreign‐body reaction to the fillers in the methylphenidate tablets, followed by superinfection by oral or cutaneous flora. Mixed flora infections with weakly pathogenic organisms may also occur.