Cordesmeyer Robert, Kauffmann Philipp, Markus Tröltzsch, Sömmer Christian, Eiffert Helmut, Bremmer Felix, Laskawi Rainer
Department of Oral and Maxillofacial Surgery, University of Göttingen, Göttingen, Germany.
Department of Oral and Maxillofacial Surgery, University of Göttingen, Göttingen, Germany.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Jul;124(1):11-15. doi: 10.1016/j.oooo.2017.02.003. Epub 2017 Feb 20.
Deep neck infections are among the most dangerous acute diseases in the head and neck region. This analysis gives an overview of the bacterial and histopathologic findings of deep neck infections.
From January 2002 to December 2012, 63 patients were diagnosed with and treated for deep neck infections at the University Medical Center Göttingen. Bacterial and histopathologic examinations were made, and the occurrence of bacterial pathogens and histopathologic findings were analyzed.
The most commonly isolated aerobic gram-positive pathogen was Streptococcus viridans (26.7%); Staphylococcus epidermidis and Staphylococcus aureus were each found in 16.7% of infections. The most commonly isolated aerobic gram-negative pathogens were Escherichia coli, Klebsiella oxytoca, and Haemophilus influenzae. In 1.6% of patients, a malignant cancer was detected.
For clear diagnosis and effective therapy, a bacteriologic investigation of deep neck infections is essential because of the heterogeneous spectrum of the detected bacteria. In contrast to Asia, where Klebsiella pneumoniae is the most common pathogen, in South Lower Saxony, Germany, we discovered a dominating spectrum of aerobic gram-positive cocci. Biopsy obtained from an abscess cavity for histologic examination should always be part of the diagnostic process in order to exclude a malignant process.
颈部深部感染是头颈部区域最危险的急性疾病之一。本分析概述了颈部深部感染的细菌学和组织病理学发现。
2002年1月至2012年12月期间，哥廷根大学医学中心对63例被诊断为颈部深部感染的患者进行了治疗。进行了细菌学和组织病理学检查，并分析了细菌病原体的发生情况和组织病理学发现。
最常分离出的需氧革兰氏阳性病原体是草绿色链球菌（26.7%）；表皮葡萄球菌和金黄色葡萄球菌在16.7%的感染病例中均有发现。最常分离出的需氧革兰氏阴性病原体是大肠杆菌、产酸克雷伯菌和流感嗜血杆菌。在1.6%的患者中检测到恶性肿瘤。
由于检测到的细菌种类具有异质性，因此对颈部深部感染进行细菌学调查对于明确诊断和有效治疗至关重要。与亚洲以肺炎克雷伯菌为最常见病原体不同，在德国下萨克森州南部，我们发现需氧革兰氏阳性球菌占主导地位。从脓肿腔获取活检组织进行组织学检查应始终作为诊断过程的一部分，以排除恶性病变。
