咽旁及咽後膿瘍合併化膿性縱隔腔炎－病例報告

Suppurative Mediastinitis Complicating Parapharyngeal and Retropharyngeal Abscesses - Case Report

鄭主敬(Chu-Ching Cheng) ； 徐銘燦(Ming-Tsan Shu) ； 林老生(Lau-Sheng Lin)

《中華民國耳鼻喉科醫學會雜誌》 31卷6期 (1996/12) Pp. 520-524

https://doi.org/10.6286/1996.31.6.520

摘要

深頸部感染是常見且可致死的疾病，尤其若併發縱隔腔炎時，即使給予抗生素治療，其死亡率仍高達40%以上。本文提出一位63歲的病人，無糖尿病、誤食異物或牙源性感染等深頸部感染致病因的病史，診斷兩側咽旁及咽後膿瘍，雖分別施行左、右側的膿瘍切開引流，膿瘍仍向下蔓延至上及前下縱隔腔，因而須照會胸腔外科行縱隔腔切開及膿瘍引流。頸部膿瘍的細菌培養則分鄂長出鏈球菌及金黃色葡萄球菌。病人於治療期間曾出現上消化道出血及吞嚥困難的併發症，但於住院後第39日在情況良好下出院。

關鍵字

咽旁膿瘍 ； 咽後膿瘍 ； 縱隔腔炎

並列摘要

Deep neck infection is a common and potentially lethal disease. The mortality rate may be up to 40% when it is compli-cated with mediastinitis. This report presents a 63-year-old male patient with bilateral parapharyngeal and retropharyn-geal abscesses. Incision and drainage of the parapharyngeal abscesses were carried out, however, the infection still spreaded to the upper and anterior mediastina. Chest surgeon was then consulted, and mediastinotomy with abscesses drainage were performed. The results of pus culture revealed streptococcus and staphylococcus infections. After an internsive care, he was discharged uneventfully on the 39th day after admission.

並列關鍵字

parapharyngeal abscess ； retropharyngeal abscess ； medias-tinitis