Balasubramanian Anusha, Shah J Redzwan, Gazali Norzi, Rajan Philip
Department of Otorhinolaryngology, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia.
Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.
BMJ Case Rep. 2017 Oct 9;2017:bcr-2017-221269. doi: 10.1136/bcr-2017-221269.
Severe extensive deep neck abscess in an infant is uncommon. We share the case of a previously well 4-month old infant who was referred for a 4-day history of fever, lethargy and left lateral neck swelling. Contrast-enhanced CT scan revealed a large 5.3×8 cm collection involving the left parapharyngeal and retropharyngeal space, causing significant airway narrowing. 40 mL of frank pus was drained via intraoral incision and drainage with the aid of endoscope, and undesirable complications from an external approach were averted. The infant was extubated 48 hours postsurgery and was discharged home well after completion of 1 week of intravenous antibiotics. The child was discharged well from our follow-up at 1 month review. We discuss the pathophysiology of deep neck space abscesses, its incidence in the paediatric population and the various management options.
婴儿严重广泛性颈部深部脓肿并不常见。我们分享一例病例，一名此前健康的4个月大婴儿因发热、嗜睡和左侧颈部肿胀4天前来就诊。增强CT扫描显示一个5.3×8厘米的大脓肿，累及左侧咽旁和咽后间隙，导致气道明显狭窄。在内镜辅助下通过口腔内切开引流排出了40毫升脓性液体，避免了外部手术方法带来的不良并发症。婴儿术后48小时拔管，静脉注射抗生素1周后顺利出院。在1个月复查时，该患儿在我们的随访中康复良好。我们讨论了颈部深部间隙脓肿的病理生理学、在儿科人群中的发病率以及各种治疗选择。
