OBJECTIVETo analyze the clinical character, diagnosis and treatment of badly necrotic pyogenic infection in cervical part with pneumatosis of vomica.

METHODSThe clinical character, diagnosis and treatment of badly necrotic pyogenic infection in cervical part with pneumatosis of vomica of 46 cases were investigated retrospectively.

RESULTSLateral and bilateral neck infection cases were 38 and 8 respectively. 30 cases formed primary pyogenic infection in cervical part with pneumatosis of vomica, and 16 did from adjacent sites. Besides the characters of the acute infection, gas storage in deep cervical part abscess was notable. CT and B Ultrasonic examination provided useful informations such as sizes, shapes, capacity, extents of abscess and the relationship between the abscess and vessel or vital organ. Diagnosis puncture and germiculture were performed before and after operation. The results showed that 25 of 46 cases were infected by staphylococcus or streptococcus, and 21 cases did by other bacterium. Exploration and drainage treatments were performed. All cases were cured except 2 died.

CONCLUSIONDiagnostic puncture, CT and/or B Ultrasonic examination are essential for diagnosis and presurgical planning. Germiculture provides reliable evidence for finding pathogeny and therapy. The most possibilities of pyogenic infection with pneumatosis of vomica in cervical part are the action of aerogenic bacterium, infection both in cervical part and chest or swallowing movement of pharynx.

Abscess ; diagnosis ; microbiology ; therapy ; Cysts ; diagnosis ; microbiology ; therapy ; Humans ; Neck ; pathology ; Necrosis ; diagnosis ; microbiology ; therapy

Non-typhoidal salmonellosis, which is increasing nowadays in Korea as well as in the developed countries, is manifested as enteritis in most cases, but it also encompasses bacteremia, intraabdominal infections, and bone, joint and soft tissue infections. These rare diseases are known to result from primary gastrointestinal infection and subsequent bacteremia with or without symptoms. We experienced a case of neck abscess caused by Salmonella serotype D, which is a rare but important differential diagnosis of neck abscess. We herein report it.
Abscess/*diagnosis/*microbiology ; Aged ; Female ; Humans ; *Liver Cirrhosis ; Neck/*microbiology/*pathology ; Salmonella/*physiology ; Salmonella Infections/*complications

OBJECTIVETo review the recent diagnosis and treatment experience with deep neck infection and emphasize the importance of radiologic evaluation, microbiology and appropriate treatment selection in these patients.

METHODSA respective review was conducted in 95 cases who were diagnosed as having deep neck from Jan. 2006 to March 2015.

RESULTSThe primary diseases in 95 patients with deep neck infection were acute tonsillitis or acute laryngitis (27 cases), infection of upper respiratory tract (23 cases), odontogenic infection or oral inflammation (16 cases), foreign bodies in esophagus (9 cases), acute cervical lymphadenitis (5 cases) and cause uncertain (15 cases). Computed tomography was performed in all of patients to identify the location, extent, and character (cellulitis in 47 cases or abscesses in 48 cases) of the infections. The locations of abscess were parapharyngeal abscess (25 cases), retropharyngeal abscess (9 cases), submaxillary space abscess (6 cases), pretracheal space abscess (5 cases) and esophageal abscess (3 cases).

COMPLICATIONSmediastinitis (2 cases), pericarditis (1 case), bilateral pneumothorax (2 cases), and upper digestive tract (1 case). Bacterial cultivation performed in 35 patients and positive results were detected in 21. All patients were given intravenous antibiotic therapy. Tracheotomy was performed in 4 cases. Preoperative contrast enhanced CT was performed in 42 patients and indicated the formation of abscess. Three cases with the symptoms of septic shock were transferred to ICU and one was cured. All the patients were cured except two who died of massive hemorrhage of upper digestive tract and septic shock.

CONCLUSIONSThe airway patency in patients with deep neck infections must be ensured. Drainage may be mandatory in selected cases at presentation or in cases who fail to respond to parenteral antibiotics within the first 24-48 hours. Imaging evaluation plays a significant role in the diagnosis and rational therapeutic management in deep neck infection. Bacterial cultivation can help to make the effective treatment and provide reliable evidence for the etiopathogenisis.

Anti-Bacterial Agents ; therapeutic use ; Bacterial Infections ; drug therapy ; Cellulitis ; pathology ; Drainage ; Esophagus ; pathology ; Foreign Bodies ; pathology ; Humans ; Laryngitis ; microbiology ; pathology ; Neck ; microbiology ; pathology ; Retropharyngeal Abscess ; pathology ; Retrospective Studies ; Tomography, X-Ray Computed ; Tonsillitis ; microbiology ; pathology ; Treatment Outcome

OBJECTIVETo study the clinicopathologic features of malignant tumors in head and neck region complicated by fungal infection.

METHODSTwenty-one cases of malignant tumors occurring in head and neck region complicated by fungal infection were retrieved from the archival file. The light microscopic findings were reviewed. Histochemical (for PAS and GMS) and immunohistochemical (for MUC5B) studies were carried out. Fungal culture results were available in 13 of the 21 cases.

RESULTSThe age of the patients ranged from 12 to 72 years (median = 48 years). The male-to-female ratio was 17:4. Eight cases (38.1%) were complicated by invasive fungal sinusitis, with orbital involvement in 6 cases and brain involvement in 1 case. The primary tumors in such cases included leukemia (n = 7) and nasopharyngeal carcinoma (n = 1). The fungi belonged to Zygomycete in 5 cases and Aspergillus in 3 cases. These patients had history of chemotherapy/radiotherapy or antibiotics usage. The remaining 13 cases of fungal infection often affected necrotic tumor tissue in nasal cavity, paranasal sinuses, pharynx, larynx and palate. The fungi involved were Aspergillus (n = 6) and Candida (n = 4). Seven of such patients had received radiotherapy. Fungal culture was positive in 9 cases. Fourteen patients had follow-up information available and six of them died of the disease.

CONCLUSIONSMalignant tumors occurring in head and neck region can be complicated by fungal infection. Invasive fungal sinusitis (due to Zygomycetes and Aspergillus) often occurs in patients with leukemia, tends to involve orbit and is associated with poor prognosis. On the other hand, Aspergillus and Candida are the commonest fungi found in the necrotic tumor tissue. Pathologic examination remains the hallmark in confirming the diagnosis and fungal typing.

Adolescent ; Adult ; Aged ; Antifungal Agents ; therapeutic use ; Aspergillosis ; drug therapy ; microbiology ; pathology ; Aspergillus ; isolation & purification ; Candida ; isolation & purification ; Candidiasis ; drug therapy ; microbiology ; pathology ; Carcinoma, Squamous Cell ; drug therapy ; microbiology ; pathology ; Child ; Female ; Follow-Up Studies ; Head and Neck Neoplasms ; drug therapy ; microbiology ; pathology ; Humans ; Leukemia ; drug therapy ; microbiology ; pathology ; Lymphoma, Extranodal NK-T-Cell ; drug therapy ; microbiology ; pathology ; Male ; Middle Aged ; Mycoses ; drug therapy ; microbiology ; pathology ; Retrospective Studies ; Sinusitis ; drug therapy ; microbiology ; pathology ; Young Adult ; Zygomycosis ; drug therapy ; microbiology ; pathology

OBJECTIVETo analyze the effective treatment of deep neck infection in children.

METHODSThirty-three cases of deep neck infection treated from September 2005 to May 2015 were retrospectively reviewed. To observe the effect of antibiotics and surgical drainage.

RESULTSAll cases were cured, including one case who was complicated with carotid artery rupture and was timely cured by vascular interventional therapy, and the cure rate was 100%.

CONCLUSIONCombined application of broad-spectrum antibiotics and effective surgical drainage are key to treat deep neck infection in children. The emergence of repeated small amount of bleeding in the nose and throat in children is an indicator for big neck vessel rupture and interventional vascular therapy may be considered.

Anti-Bacterial Agents ; therapeutic use ; Carotid Artery Diseases ; complications ; Child ; Drainage ; Hemorrhage ; complications ; Humans ; Neck ; microbiology ; pathology ; Nose ; Pharynx ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To investigate the diagnosis and treatment of deep neck infection. METHOD: Clinical data of 45 cases treated in our department from Jan 2003 to Apr 2012 were retrospectively analysed. RESULT: Nineteen cases of deep neck infection in 45 patients without abscess formation were treated with high-dose antibiotics. Performed computed tomography, the other 26 patients were treated by abscess incision and drainage, the wound healed well without complications. CONCLUSION Early diagnosis and treatment of deep neck infection is very important. Once deep neck abscess is diagnosed, early abscess surgical drainage, appropriate antibiotics and nutrition supporting treatment are effective for deep neck abscess.
Abscess ; diagnostic imaging ; therapy ; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Bacterial Infections ; diagnostic imaging ; therapy ; Child ; Child, Preschool ; Drainage ; Female ; Humans ; Male ; Middle Aged ; Neck ; microbiology ; pathology ; Radiography ; Retrospective Studies ; Young Adult