Herr R D, Murdock R T, Davis R K
University of Utah School of Medicine, Salt Lake City.
Am Fam Physician. 1991 Sep;44(3):878-88.
The head and neck contain a number of spaces that can be invaded by organisms of the mouth or by spread of cervical osteomyelitis. Infection in these spaces may progress from superficial infection to cellulitis to the formation of an abscess requiring immediate drainage. Spread of infection between spaces depends on anatomic location. Most patients require hospitalization and intravenous antibiotic therapy. Because a deep space infection may be occult, a high index of suspicion is required for diagnosis. Early recognition is necessary to avoid tissue damage, bacteremia or airway compromise. The possibility of deep space infection should be considered in any patient who does not respond to the usual treatment of an abscessed tooth or tonsillitis. This type of infection also should be considered in a toxic patient who has a fever of unknown origin, with or without blood cultures that show anaerobic organisms. Computed tomography or magnetic resonance imaging is usually necessary to locate the infection and to detect suppuration that will be amenable to surgical exploration and drainage.
头颈部包含许多间隙，口腔中的微生物或颈椎骨髓炎的扩散可侵入这些间隙。这些间隙中的感染可能从浅表感染发展为蜂窝织炎，进而形成需要立即引流的脓肿。间隙之间的感染扩散取决于解剖位置。大多数患者需要住院并接受静脉抗生素治疗。由于深部间隙感染可能隐匿，诊断时需要高度怀疑。早期识别对于避免组织损伤、菌血症或气道受损至关重要。对于任何对脓肿性牙齿或扁桃体炎的常规治疗无反应的患者，都应考虑深部间隙感染的可能性。对于不明原因发热的中毒患者，无论血培养是否显示厌氧菌，也应考虑这种类型的感染。通常需要计算机断层扫描或磁共振成像来定位感染并检测适合手术探查和引流的化脓情况。
