頸部顏面放線菌感染－病例報告

Cervicofacial Actinomycosis - Case Report

范振杰(Chen-Chieh Fan) ； 陳正文(Jeng-Wen Chen) ； 林堂烈(Tarng-Lieh Lin) ； 王華恭(Hua-Kung Wang) ； 林書馨(Hshu-Hshing Lin)

《中華民國耳鼻喉科醫學雜誌》 37卷3期 (2002/03) Pp. 207-210

https://doi.org/10.6286/2002.37.3.207

摘要

放線菌症是一種罕見的慢性化膿性感染，典型的臨床表現是有軟組織腫脹，膿液中含有‘硫磺顆粒’，有時會破裂形成廔管。因抗生素的廣泛使用，此疾病之發生率已大幅降低。本科於2000年間經歷一頸部顏面型放線菌症之病例，病患右頰慢性腫脹，經一般抗生素藥物治療無效，引流之膿液可見‘硫磺顆粒’，經細菌培養證實為放線菌感染。經手術引流並給予amoxicillin治療，效果良好。建議臨床上若見到頭頸部之軟組織腫脹，經一般治療無效時，應將此症納入考慮。

關鍵字

放線菌 ； 頸部顏面型 ； 培養 ； 硫磺顆粒

並列摘要

Actinomycosis is a chronic suppurative bacterial infection. It most commonly affects the cervicofacial area, typically presenting as a soft tissue swelling and fistula with “sulfur granules” often seen in a purulent discharge. Culture of the organism is often difficult. With the general use of antibiotic, this disease has become a rare medical entity. We report a case of cervicofacial actinomycosis in a 73-year-old diabetic patient. His initial presentation was left cheek swelling, which was not responding to an empirical antibiotic therapy. “Sulfur granules” were identified in the draining discharge and bacterial culture confirmed the diagnosis of actinomycosis. His disease was cured after a surgical drainage followed by amoxicillin therapy. We conclude that a cervicofacial swelling not respond-ing to. an ordinary antibiotic therapy should raise the suspicion of actinomycosis, and a careful anaerobic culturing procedure is necessary for obtaining positive cultures.

並列關鍵字

actinomycosis ； cervicofacial ； culture ； sulfur ； granule