DEEP NECK INFECTION ; A REPORT OF FIVE CASES
From November 1995 to July 1996, we treated five patients with deep neck infection, containing two cases of gas gangrene. We also discussed recent 36 cases of deep neck infection including our 5 cases. Recent case reports of deep neck infection, especially cases of non-Clostridial gas gangrene, are...
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          | Published in | JIBI INKOKA TEMBO Vol. 40; no. 2; pp. 180 - 185 | 
|---|---|
| Main Authors | , , | 
| Format | Journal Article | 
| Language | Japanese | 
| Published | 
            Society of Oto-rhino-laryngology Tokyo
    
        1997
     耳鼻咽喉科展望会  | 
| Subjects | |
| Online Access | Get full text | 
| ISSN | 0386-9687 1883-6429  | 
| DOI | 10.11453/orltokyo1958.40.180 | 
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| Abstract | From November 1995 to July 1996, we treated five patients with deep neck infection, containing two cases of gas gangrene. We also discussed recent 36 cases of deep neck infection including our 5 cases. Recent case reports of deep neck infection, especially cases of non-Clostridial gas gangrene, are increasing. For the treatment administration of antibiotics protecting against both aerobic and anaerobic bacterial infection is necessary. For example, administration of PIPC and CLDM is useful as the first choice. We treated 5 cases by administration of PIPC and CLDM, with surgical drainage for 3 cases. The appropriate therapy should be carried out quickly before the infection leads to a severe state and the planing of surgical drainage is also necessary at the same time. For the planing of surgical treatment CT scan is useful. Therefore if abscess formation is suspected CT scan should be done early without hesitations. Because the patients with deep neck infections often visit clinicians whose specialty is not otorhinolaryngology, the pathogenesis and severity should be discussed sufficiently with them. We have to care the cases which possibly lead to severe deep neck infections, such as the cases with diffuse neck swelling and redness, peri-tonsillitis, odontogenous infection, to prevent an increase in such cases. | 
    
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| AbstractList | From November 1995 to July 1996, we treated five patients with deep neck infection, containing two cases of gas gangrene. We also discussed recent 36 cases of deep neck infection including our 5 cases. Recent case reports of deep neck infection, especially cases of non-Clostridial gas gangrene, are increasing. For the treatment administration of antibiotics protecting against both aerobic and anaerobic bacterial infection is necessary. For example, administration of PIPC and CLDM is useful as the first choice. We treated 5 cases by administration of PIPC and CLDM, with surgical drainage for 3 cases. The appropriate therapy should be carried out quickly before the infection leads to a severe state and the planing of surgical drainage is also necessary at the same time. For the planing of surgical treatment CT scan is useful. Therefore if abscess formation is suspected CT scan should be done early without hesitations. Because the patients with deep neck infections often visit clinicians whose specialty is not otorhinolaryngology, the pathogenesis and severity should be discussed sufficiently with them. We have to care the cases which possibly lead to severe deep neck infections, such as the cases with diffuse neck swelling and redness, peri-tonsillitis, odontogenous infection, to prevent an increase in such cases.
抗生物質の発達した近年においても深頸部感染症の報告は増加傾向にある。中でも非クロストリジウム性の頭頸部ガス壊疽症例が目立つ。当科でも平成7年11月から平成8年7月までの9ヵ月間に5例の深頸部感染症を経験した。この内2例はガス産生を伴っていた。好気性菌と嫌気性菌の混合感染, 薬剤耐性嫌気性菌の増加を考慮し, 初期治療に用いる抗生物質の選択は慎重になされなければならない。深頸部感染症は重症化する以前に耳鼻咽喉科以外の診療機関で加療されることも多くその病態, 危険性について多くの臨床家と意見交換がなされるべきであり, 深頸部感染症へと移行する可能性のある症例を早期に見極め, その増加防止に力を注ぐ必要性があると考えられた。 From November 1995 to July 1996, we treated five patients with deep neck infection, containing two cases of gas gangrene. We also discussed recent 36 cases of deep neck infection including our 5 cases. Recent case reports of deep neck infection, especially cases of non-Clostridial gas gangrene, are increasing. For the treatment administration of antibiotics protecting against both aerobic and anaerobic bacterial infection is necessary. For example, administration of PIPC and CLDM is useful as the first choice. We treated 5 cases by administration of PIPC and CLDM, with surgical drainage for 3 cases. The appropriate therapy should be carried out quickly before the infection leads to a severe state and the planing of surgical drainage is also necessary at the same time. For the planing of surgical treatment CT scan is useful. Therefore if abscess formation is suspected CT scan should be done early without hesitations. Because the patients with deep neck infections often visit clinicians whose specialty is not otorhinolaryngology, the pathogenesis and severity should be discussed sufficiently with them. We have to care the cases which possibly lead to severe deep neck infections, such as the cases with diffuse neck swelling and redness, peri-tonsillitis, odontogenous infection, to prevent an increase in such cases.  | 
    
| Author | Baba, Syunkichi Akimoto, Rika Fujikura, Terumichi  | 
    
| Author_FL | 秋元 利香 馬場 俊吉 藤倉 輝道  | 
    
| Author_FL_xml | – sequence: 1 fullname: 藤倉 輝道 – sequence: 2 fullname: 秋元 利香 – sequence: 3 fullname: 馬場 俊吉  | 
    
| Author_xml | – sequence: 1 fullname: Akimoto, Rika organization: Department of Otolaryngology, Yatsu Hoken Hospital – sequence: 1 fullname: Baba, Syunkichi organization: Department of Otolaryngology, Nippon Medical School – sequence: 1 fullname: Fujikura, Terumichi organization: Department of Otolaryngology, Yatsu Hoken Hospital  | 
    
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| References | 5) 中島庸也, 富谷義徳, 千葉伸太郎, 他 : ガス形成性深頸部感染症について.耳展36 : 286-294, 1993. 16) 品川長夫 : 嫌気性菌感染症/外科領域.臨床と微生物21 : 71-74, 1994. 13) 宮崎修一 : 無芽胞嫌気性菌とその感染症/発生機序-混合感染を中心に.臨床と微生物19 : 11-17, 1992. 2) 石塚鉄男, 仙波哲雄, 太田康, 他 : 頸部のガス壊疽例.耳鼻臨床86 : 113-118, 1993. 11) 佐藤 進, 坂口正範, 椎名麻美, 他 : 深頸部感染症の5症例.耳鼻臨床89 : 81-87, 1996. 1) 安藤敬子, 佐藤公輝, 田淵伴秀 : 深頸部膿瘍の3例.耳鼻38 : 214-219, 1992. 10) 石津吉彦 : 頸部ガス蜂窩織炎例.耳鼻臨床88 : 1329-1334, 1995. 15) Stiernberg CM : Deep-neck space infections. Arch Otolalyngol Head Neck Surg 112 : 1274-1279, 1986. 8) 河北誠二, 兵頭政光, 森 敏裕, 他 : 非クロストリジウム性頸部ガス壊疽例.耳鼻臨床87 : 1719-1725, 1994. 3) 鈴村栄久, 山際幹和, 浜口幸吉, 他 : 縦隔洞炎へ進行した深頸部感染症2症例.耳鼻臨床86 : 1315-1320, 1993. 14) 中村功 : 嫌気性菌感染症/内科領域.臨床と微生物21 : 67-70, 1994. 6) 秋定健, 竹本琢司, 武浩太郎, 他 : 深頸部感染症の2例.耳鼻40 : 8-13, 1994. 12) 堀内正敏, 飯田政弘, 牧野弘治, 他 : 深頸部感染症の合併症とその予防.JOHNS 12 : 578-582, 1996. 17) 副島林造, 斎藤 厚 : 抗菌薬見直しシリーズ/リン酸クリンダマイシン.JPn J Antibiot 47 : 845-852, 1994. 9) 本多伸光, 中村光士郎, 木谷伸治, 他 : 深頸部感染症の7症例.耳鼻臨床88 : 483-491, 1995. 4) 大井聖幸, 稲村直樹, 鈴木 守, 他 : 頭頸部ガス壊疽 (いわゆるガス蜂窩織炎) の3症例.日耳鼻96 : 1079-1085, 1993. 7) 福島泰裕, 坂本邦彦, 森山一郎, 他 : 当科における深頸部感染症症例.耳鼻40 : 51-56, 1994.  | 
    
| References_xml | – reference: 2) 石塚鉄男, 仙波哲雄, 太田康, 他 : 頸部のガス壊疽例.耳鼻臨床86 : 113-118, 1993. – reference: 8) 河北誠二, 兵頭政光, 森 敏裕, 他 : 非クロストリジウム性頸部ガス壊疽例.耳鼻臨床87 : 1719-1725, 1994. – reference: 7) 福島泰裕, 坂本邦彦, 森山一郎, 他 : 当科における深頸部感染症症例.耳鼻40 : 51-56, 1994. – reference: 15) Stiernberg CM : Deep-neck space infections. Arch Otolalyngol Head Neck Surg 112 : 1274-1279, 1986. – reference: 3) 鈴村栄久, 山際幹和, 浜口幸吉, 他 : 縦隔洞炎へ進行した深頸部感染症2症例.耳鼻臨床86 : 1315-1320, 1993. – reference: 12) 堀内正敏, 飯田政弘, 牧野弘治, 他 : 深頸部感染症の合併症とその予防.JOHNS 12 : 578-582, 1996. – reference: 16) 品川長夫 : 嫌気性菌感染症/外科領域.臨床と微生物21 : 71-74, 1994. – reference: 4) 大井聖幸, 稲村直樹, 鈴木 守, 他 : 頭頸部ガス壊疽 (いわゆるガス蜂窩織炎) の3症例.日耳鼻96 : 1079-1085, 1993. – reference: 10) 石津吉彦 : 頸部ガス蜂窩織炎例.耳鼻臨床88 : 1329-1334, 1995. – reference: 5) 中島庸也, 富谷義徳, 千葉伸太郎, 他 : ガス形成性深頸部感染症について.耳展36 : 286-294, 1993. – reference: 13) 宮崎修一 : 無芽胞嫌気性菌とその感染症/発生機序-混合感染を中心に.臨床と微生物19 : 11-17, 1992. – reference: 6) 秋定健, 竹本琢司, 武浩太郎, 他 : 深頸部感染症の2例.耳鼻40 : 8-13, 1994. – reference: 9) 本多伸光, 中村光士郎, 木谷伸治, 他 : 深頸部感染症の7症例.耳鼻臨床88 : 483-491, 1995. – reference: 1) 安藤敬子, 佐藤公輝, 田淵伴秀 : 深頸部膿瘍の3例.耳鼻38 : 214-219, 1992. – reference: 11) 佐藤 進, 坂口正範, 椎名麻美, 他 : 深頸部感染症の5症例.耳鼻臨床89 : 81-87, 1996. – reference: 14) 中村功 : 嫌気性菌感染症/内科領域.臨床と微生物21 : 67-70, 1994. – reference: 17) 副島林造, 斎藤 厚 : 抗菌薬見直しシリーズ/リン酸クリンダマイシン.JPn J Antibiot 47 : 845-852, 1994.  | 
    
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| Snippet | From November 1995 to July 1996, we treated five patients with deep neck infection, containing two cases of gas gangrene. We also discussed recent 36 cases of... | 
    
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| SubjectTerms | antibiotics deep neck infection non-Clostridial gas gangrene  | 
    
| Title | DEEP NECK INFECTION ; A REPORT OF FIVE CASES | 
    
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