Nedrebø Torbjørn, Bruun Trond, Skjåstad Rune, Holmaas Gunhild, Skrede Steinar
Hyperbaric Medical Unit, Dept of Occupational Medicine, Haukeland University Hospital; ; Department of Biomedicine, University of Bergen;
Department of Medicine, Haukeland University Hospital; ; Institute of Medicine, University of Bergen;
Infect Dis Rep. 2012 Feb 28;4(1):e21. doi: 10.4081/idr.2012.e21. eCollection 2012 Jan 2.
Necrotizing infections of the head and neck are rare conditions in our hospital. Clinical and microbiological characteristics of three consecutive cases treated in Haukeland University Hospital in western Norway in the year 2010 are described. Two cases of Lemierre's syndrome and one case with a descending necrotizing mediastinitis (DNM) were diagnosed. All three cases were treated with broad spectrum antibiotics and in two cases surgery was possible. Hyperbaric oxygen treatment (HBOT) with intensive care facilities became recently available at our hospital, and this treatment was used in all these patients regardless of surgery. In one case we describe the use of HBOT on the basis of strong clinical suspicion of anaerobic infection only. Bacterial identification by partial sequencing of the 16SrDNA gene proved to be a useful supplement to conventional culture techniques. All the cases all demonstrated a significant clinical improvement after introduction of HBOT. When HBOT is available, it should be considered as adjunctive treatment in extensive infections with anaerobes.
头颈部坏死性感染在我院较为罕见。本文描述了2010年在挪威西部豪克兰大学医院连续治疗的三例患者的临床和微生物学特征。诊断出两例勒米尔综合征和一例下行性坏死性纵隔炎（DNM）。所有三例患者均接受了广谱抗生素治疗，其中两例可行手术治疗。我院最近配备了重症监护设施的高压氧治疗（HBOT），所有这些患者无论是否接受手术均接受了该治疗。在其中一例中，我们仅基于对厌氧菌感染的强烈临床怀疑描述了HBOT的使用。通过16SrDNA基因部分测序进行细菌鉴定被证明是对传统培养技术的有用补充。所有病例在引入HBOT后均显示出显著的临床改善。当有HBOT可用时，应将其视为厌氧菌广泛感染的辅助治疗方法。
