Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California 94115, USA.
Laryngoscope. 2012 Dec;122(12):2688-9. doi: 10.1002/lary.23334. Epub 2012 May 29.
Otolaryngologists commonly evaluate patients with findings suspicious for deep space soft tissue infections of the neck. In this case, a woman with a history of injection drug use (IDU) presented with dysphagia, odynophagia, and neck pain. Multiple neck abscesses, too small to drain, were seen on imaging. Despite broad-spectrum intravenous antibiotics, she unexpectedly and rapidly developed respiratory failure requiring intubation. Further work-up diagnosed wound botulism (WB). To our knowledge, this is the first report of WB presenting as a deep neck space infection, and illustrates the importance of considering this deadly diagnosis in patients with IDU history and bulbar symptoms.
耳鼻喉科医生通常会评估疑似颈部深部软组织感染的患者。在这个病例中，一名有注射吸毒史（IDU）的女性出现吞咽困难、咽痛和颈部疼痛。影像学检查发现多个颈部脓肿，但太小无法引流。尽管使用了广谱静脉抗生素，她还是出人意料地迅速出现呼吸衰竭，需要插管。进一步的检查诊断为创伤性肉毒中毒（WB）。据我们所知，这是首例报告的以深部颈部间隙感染为表现的 WB，说明了在有 IDU 病史和球部症状的患者中考虑这一致命诊断的重要性。
