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头颈部急症:细菌性脑膜炎、脑炎、脑脓肿、上呼吸道梗阻和颈静脉化脓性血栓性静脉炎。

Head and neck emergencies: bacterial meningitis, encephalitis, brain abscess, upper airway obstruction, and jugular septic thrombophlebitis.

机构信息

Department of Internal Medicine, Division of Infectious Diseases, Eastern Virginia Medical School, Norfolk, VA, USA.

出版信息

Med Clin North Am. 2012 Nov;96(6):1107-26. doi: 10.1016/j.mcna.2012.08.002. Epub 2012 Sep 13.

Abstract

Head and neck infectious disease emergencies can be rapidly fatal without prompt recognition and treatment. Empiric intravenous (IV) antibiotics should be initiated immediately in any patient with suspected bacterial meningitis, and IV acyclovir in any patient with suspected encephalitis. Surgical intervention is often necessary for brain abscesses, epiglottitis, and Ludwig's angina. A high index of suspicion is often needed to diagnose epiglottitis, Ludwig's angina, and Lemierre's syndrome. Brain infections can have high morbidity among survivors. In this article, the causes, diagnostic tests, treatment, and prognosis are reviewed for some of the more common head and neck infectious disease emergencies.

摘要

头颈部感染性疾病急症如果未能及时识别和治疗,可能迅速致命。任何疑似细菌性脑膜炎的患者都应立即给予经验性静脉(IV)抗生素治疗,任何疑似脑炎的患者都应给予 IV 阿昔洛韦治疗。脑脓肿、会厌炎和路德维希咽峡炎常需手术干预。诊断会厌炎、路德维希咽峡炎和勒米埃氏综合征时往往需要高度怀疑。脑感染可使幸存者的发病率居高不下。本文回顾了一些较为常见的头颈部感染性疾病急症的病因、诊断试验、治疗和预后。

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