Aderdour L, Hassani R, Nejmi H, Elfakiri M M, Maliki O, Droussi H, Sassi A, Younous S, Samkaoui M A, Raji A
Service ORL et Chirurgie Cervicofaciale, Hôpital El-Antaki, CHU Mohammed-VI, Marrakech, Maroc.
Ann Endocrinol (Paris). 2008 Dec;69(6):526-9. doi: 10.1016/j.ando.2008.05.003. Epub 2008 Oct 18.
Retropharyngeal abscess, a rare event in adults, is usually observed in immunodeficient persons or subsequent to foreign bodies. We report a case of retropharyngeal abscess which revealed diabetes mellitus. A 47-year-old woman with an uneventful history complained of fever, dysphagia and trismus. Clinical findings were swelling of the pharyngeal posterior wall. The CT scan showed an abscess in the retropharyngeal space. Puncture revealed the purulent nature of the collection. The bacteriological study identified a Gram-negative aerobic germ (Citrobacter freundii). Laboratory tests disclosed diabetes mellitus with ketosis. The treatment consisted in surgical drainage and lavage of the retropharyngeal space using a saline solution with gentamycin associated with infusion of appropriate antibiotics. Abscess formation in the retropharyngeal space is a rare event in adults. The immunological status of the patient should be carefully explored. Management requires drainage of the collection and infusion of active antibiotics.
咽后脓肿在成年人中较为罕见,通常见于免疫功能低下者或异物进入后。我们报告一例咽后脓肿病例,该病例并发糖尿病。一名既往史无异常的47岁女性,出现发热、吞咽困难和牙关紧闭症状。临床检查发现咽后壁肿胀。CT扫描显示咽后间隙有脓肿。穿刺证实积液为脓性。细菌学研究鉴定出一种革兰氏阴性需氧菌(弗氏柠檬酸杆菌)。实验室检查发现糖尿病伴酮症。治疗方法包括手术引流和用含庆大霉素的生理盐水冲洗咽后间隙,并输注适当的抗生素。咽后间隙脓肿形成在成年人中是罕见事件。应仔细检查患者的免疫状态。治疗需要排出积液并输注有效的抗生素。