Infections of the head and neck.
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Adolescent↗
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Results for “Peritonsillar Abscess”
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[Clinical experience with flomoxef in the pediatric field].
Flomoxef (FMOX, 6315-S) was given intravenously to 21 children with the following acute bacterial infections; 10 cases of bronchopneumonia, 3 cases each of purulent lymphadenitis and urinary tract infection, 2 cases of staphylococcal scalded skin syndrome and 1 case each of peritonsillar abscess, pyothorax and purulent meningitis. Good clinical responses were obtained in 18 out of 21 patients, and bacteriologically, all of the 17 isolated strains were eradicated. No side effect was observed except for 1 case with soft stool and 2 cases of eosinophilia. From the above clinical results, it is apparent that FMOX is a useful antibiotic for treating pediatric patients with various bacterial infections.
Age Factors↗
Dysphonia: an unusual presentation of spontaneous pneumomediastinum.
Spontaneous pneumomediastinum, an unusual entity in children, is rarely associated with dysphonia. Muffling of the voice is more commonly associated with such pediatric illnesses as retropharyngeal or peritonsillar abscesses and epiglottitis. We report a 14-year-old female with spontaneous pneumomediastinum who presented to the emergency department with dysphonia as the primary complaint. Pneumomediastinum should be included in the differential diagnosis of dysphonia.
Adolescent↗
[Evaluation of cefotiam in pediatric field (author's transl)].
Studies on the antibacterial activity, absorption and excretion and also clinical investigation in the field of pediatrics have been carried out with cefotiam (SCE-963, CTM), a new cephalosporin antibiotic. 1) The MICs of CTM against the following clinical isolates were measured and compared with those of CEZ: S. aureus (81 strains), E. coli (27) and K. pneumoniae (27), with CTM being inferior by 1 tube in S. aureus, being superior by 2 to 3 tubes in E. coli and by about 2 - 3 tubes in K. pneumoniae. 2) Absorption and excretion. After intravenous one shot injection at dose levels of 10 mg/kg and 20 mg/kg, the peak in the serum concentration was shown in the 15-minute value with 18.1 and 36.6 mcg/ml for 10 mg/kg and 20 mg/kg, respectively. The half-life in ;the serum was 1.14 and 0.61 hours, respectively. In the case of 1-hour intravenous drip infusion at a dose level of 10 mg/kg, it was 14.3 mcg/ml, with 0.98-hour half-life in the serum. The recovery rates from the urine within 0 to 6 hours were 50.6% and 66.2% in the case of intravenous one shot injection at dose levels of 10 mg/kg and 20 mg/kg, respectively, with 71.1% in the case of the 1-hour intravenous drip infusion. 3) Two to 3 hours after intravenous one shot injection of CTM in H. influenzae-meningitis every 4 hours at a dose level of 62.5 mg/kg at one time, the cerebrospinal fluid concentration of CTM was only 2.12 to 10.0 mcg/ml, and this fact suggests that CTM is a useful cephalosporin for treating purulent meningitis. 4) CTM was administered in 19 clinical cases, with the results being: excellent in 4 out of 4 cases of bronchitis; excellent in 5 and good in 1 out of 6 cases of pneumonia; excellent in 3 cases of pyelitis; good in purulent parotitis, purulent meningitis and bacterial pericarditis; and excellent in peritonsillar abscess, purulent osteomyelitis and staphylococcal scalded skin syndrome (S.S.S.S.). No side effects have been observed in all cases. As for abnormal laboratory findings, 3 cases of eosinophilia were seen.
Age Factors↗
[Clinical bacteriological studies on cefotiam and cefsulodin in the field of otorhinolaryngology].
Clinical bacteriological studies on cefotiam and cefsulodin in the field of otorhinolaryngology were carried out and the following results were obtained. 1) Aerobic and anaerobic Gram-positive bacteria were dominantly isolated from the clinical materials sent to the center from the clinical institutes. 2) It was considered that Streptococcus pneumoniae, Haemophilus influenzae and beta-Streptococcus played an important role in the primary infections in the field of otorhinolaryngology. Staphylococcus aureus was also frequently isolated from the primary infections. Peptostreptococcus spp. was dominantly isolated from peritonsillar abscess. Gram-negative bacilli (GNB) were mainly isolated from the chronic secondary infections. Among GNB, Pseudomonas aeruginosa and Proteus spp. were more frequently isolated. Staphylococcus aureus was also constantly detected in the secondary infections together with GNB. Anaerobic bacteria were isolated from 20.1% of the patients with chronic otitis media and 27.1% of sinusitis. 3) Cefotiam showed potent antibacterial activities against most isolates of Gram-positive and Gram-negative bacteria. 4) Cefsulodin showed potent antibacterial activities against clinically isolated Pseudomonas aeruginosa. Staphylococcus aureus and beta-Streptococcus were also susceptible to cefsulodin.
Adolescent↗
[Clinical effect of a cephalosporin derivative, cefotiam, on otorhinolaryngologic infections].
CTM was administered at dose levels of 1 to 3 g a day to 77 cases of otorhinolaryngological infections, and the following results were obtained: The effect of the drug was determined in 75 cases. The responders were 3 out of 5 (60.0%) in acute suppurative otitis media, 4 out of 11 (36.4%) in chronic suppurative otitis media, 39 out of 43 (90.7%) in tonsillitis and peritonsillar abscess and 12 out of 16 (75.0%) in other diseases, a total of 58 out of 75 cases (77.3%). The bacteriological effect of CTM was evaluated in 53 cases, and bacterial eradication was demonstrated in 41 cases (77.4%). Also, its antibacterial potency was 2 to 4 times superior in comparison to that of CEZ against isolated bacteria in which MICs were measurable. Side effects which were neither severe nor specific were recognized in 3 out of 77 cases (3.9%). In the cases with abnormal laboratory values, none was determinable to be attributed to CTM.
Adolescent↗
[Clinical experience with cefotiam in otorhinolaryngologic infections].
Clinical studies of cefotiam (CTM), a new cephalosporin derivative, in otorhinolaryngological field were performed, and the results were summarized as follows. CTM was intravenously injected to 31 cases of otorhinolaryngological infections in daily dose of 1--4 g. Clinical efficacy was 33.3% in acute otitis media and chronic otitis media (acute exacerbation) (6 cases), 90% in acute tonsillitis (including peritonsillitis, peritonsillar abscess) (20 cases), 50% in acute pharyngitis (2 cases), 100% in acute sinusitis (2 cases) and 100% in epiglottis abscess (1 case), respectively. Bacteriological efficacy was 80% for beta-Streptococcus, 100% for K. pneumoniae, 50% for P. aeruginosa, and 85.7% for Peptococcus and Peptostreptococcus, respectively. No difference was observed in various daily doses for clinical efficacy. As for side effects and laboratory findings, eruption in 1 case, elevation of GOT in 1 case and elevation of GOT, GPT in 2 cases were observed. But, all of the cases were normalized after stoppage of administration or postadministration.
Adult↗
Fusobacterium necrophorum septicemia following oropharyngeal infection.
Fusobacterium necrophorum septicemia developed in five patients after an oropharyngeal infection. Four patients had sore throat or neck pain, and two had findings of jugular vein septic thrombophlebitis. Metastatic abscesses, including embolic pneumonia, empyema, septic arthritis, and osteomyelitis, also occurred. Four patients recovered and one died. Proper treatment requires recognition of the oropharyngeal source of the septicemia and its differentiation from endocarditis. Antibiotic therapy should be prolonged, and metastatic abscesses drained.
Adolescent↗
An atypical pathway of infection in an adolescent with a deep neck space abscess.
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Adolescent↗
Necrotizing fasciitis of the head and neck with intrathoracic extension.
We present the case history of a white male patient who initially presented in the Emergency Department with a peritonsillar abscess and subsequently returned several days later with necrotizing cervical fasciitis with intrathoracic extension. The successful treatment, utilizing surgical debridement and hyperbaric oxygen, will be discussed for this disease, which causes up to 50% or greater mortality.
Bacteroides fragilis↗
[Croup syndrome].
Common causes of acute laryngotracheobronchitis (LTB) are viral infections. More rarely, bacterial germs, unspecific irritants, foreign bodies, rachitic laryngospasm, mild malformation, tumours, C1 esterase inhibitor deficiency, bilateral vocal cord paralysis, and psychogenic laryngospasm may be responsible for croup. Symptoms similar to epiglottitis may occur in pharyngitis based on common bacterial tonsillitis or infectious mononucleosis and peritonsillar abscess. It is decisively important to establish a precise diagnosis to provide for an appropriate therapy. Viral croup of mild degree is often sufficiently treated by cold and moistened air and--if necessary--prednisolone. In serious disease, oxygen insufflation and adrenaline (epinephrine) are useful. Recurrent croup is due to an unspecific hyperreactivity of tracheobronchial mucosa. It often leads to asthma. Consequently, preventive measures have to be considered similar to patients with bronchial hyperreactivity. Vaccination with haemophilus influenzae type b vaccine has proved effective and safe. The disease has therefore become impressively less frequent.
Anti-Bacterial Agents↗
[Anaerobic infections in the head and neck area. Current status of knowledge].
The classification of anaerobic infections and the most common organisms affecting the head and neck, pathogenesis diagnosis and current therapy are reported. Certain types of infections are particularly important for anaerobic bacteria and include actinomycosis, infectious complications of chronic otitis media or sinusitis, phlegmon of the floor of the mouth, peritonsillar abscess, retro-(para-)pharyngeal abscess, neck space infections, mediastinitis, wound infections following head and neck surgery and septic complications.
AIDS-Related Opportunistic Infections↗
Descending necrotizing mediastinitis and respiratory distress syndrome treated by aggressive surgical treatment.
This paper describes the case of a patient who developed a pharyngotonsillitis and Ludwig's angina, and as a complication the most rare and grave mediastinitis, a descending necrotizing mediastinitis. The patient developed and adult respiratory distress syndrome secondary to mediastinal spread of a peritonsillar abscess. Only the combination of "aggressive" surgical and medical therapy resulted in survival of the patient. Important is the management of patients in Critical Care presenting complications associated with this illness.
Adult↗
[A successful surgical case of descending necrotizing mediastinitis with fistula formation to the right main bronchus].
Descending necrotizing mediastinitis (DNM) is extremely rare and one of the most lethal forms of mediastinitis, even in the era of antibiotics. We have recently treated a 65-year-old man who was diagnosed as having a fistula to the right main bronchus caused by DNM secondary to a peritonsillar abscess. Surgical treatment consisted in closing the right bronchial fistula and covering it with the latissimus dorsi muscle flap and mediastinal drainage through thoracotomy. Postoperative course was uneventful. This is the second known reported case of a successful operation for DNM with bronchial fistula.
Aged↗
Postoperative bleeding in tonsillectomy patients.
A three-year retrospective study was performed on 494 patients to compare the effects of two techniques of tonsillectomy, with respect to rates of postoperative bleeding. One surgeon performed primarily mechanical dissections, while the other primarily performed electrocautery dissections. Intraoperative blood loss was assessed and correlated to the age and gender of the patient and to the size of the tonsil. Postoperative bleeding was seen in 2.8% of patients who underwent electrocautery tonsillectomy and in 7.6% of patients who underwent mechanical tonsillectomies. Patients undergoing electrocautery dissection lost an average of 37 ml of blood intraoperatively, whereas those undergoing mechanical dissection lost 105 ml. Mechanical tonsillectomies exhibited higher intraoperative blood loss than electrocautery tonsillectomies. A higher rate of postoperative bleeding was seen in mechanical tonsillectomies, but this difference was lost when peritonsillar abscesses were removed from the study.
Adolescent↗
Odontogenic infections: Part one. Anatomy and radiology.
Odontogenic infections are frequently encountered by the dentist. The signs and symptoms of these common dental emergencies are outlined in this two-part article. A thorough knowledge of the fascial planes and anatomical routes of infection spread is a critical prerequisite to understanding the clinical manifestations, potential complications, and appropriate management of these infections.
Adult↗
[AIDS manifestations in otorhinolaryngology].
The otorhinolaryngological signs of AIDS are reviewed (both analysis and synthesis) following the chronological order of the literature. The earliest clinical pictures, their frequency and time of onset, are described by the authors studied. In 1986 the ENT signs of this disease were well known, and in our region the same multiple, polyfacetic aspects are seen. Personal experience of this is described, emphasizing how seldom the diagnosis has been made, except early on. Usually the cases seen and diagnosed by the Department of Infectious Diseases were referred for specialist opinion. The commonest findings were, amongst the opportunist infections: oropharyngeal and oesophageal candidiasis, and tuberculous adenopathies. Classical ENT pathology was represented by sinusitis and to a lesser extent by otitis and tonsillitis. The tumours seen were non-Hodgkin lymphomas, but no Hodgkin's or Burkitt's lymphomas. There was an unusual case of 'high grade centroblastic lymphoma', localized to the tonsil and presenting as necrotic tonsillitis and peritonsillar abscess. Recently a patient with a large pharyngeal tumour (still being investigated) has been provisionally diagnosed as having a cavernous angioma. Both these patients were diagnosed by us, since we saw the first sign of the disease. We have seen few Kaposi's sarcomas, since cutaneous and oral lesions are not usually referred to us.
Acquired Immunodeficiency Syndrome↗
Hyperbaric oxygen as an adjunctive treatment for descending necrotizing mediastinitis: a case report.
Descending necrotizing mediastinitis is a rare but serious complication of oropharyngeal and deep neck infection which spreads down to the mediastinum via the cervical-facial planes. Its mortality rate remains high even with aggressive surgical drainage and appropriate antibiotics. Here, a case of descending necrotizing mediastinitis secondary to peritonsillar abscess is reported. It was successfully treated with hyperbaric oxygen and antibiotics followed by surgical drainage. Based on this report, hyperbaric oxygen therapy might be of great value as an adjunctive management to control this fatal infection.
Anti-Bacterial Agents↗