Ajeigbe Teslimat, Ria Basmal, Wates Emma, Mattine Samuel
Oral and Maxillofacial Unit, Worcestershire Royal Hospital, Worcester, Worcestershire, UK.
Department of Oral Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
BMJ Case Rep. 2020 Dec 22;13(12):e236449. doi: 10.1136/bcr-2020-236449.
A 50-year-old Caucasian man presented to the emergency department during the early stages of the COVID-19 pandemic with a rapidly progressive facial swelling, fever, malaise and myalgia. The patient had recently travelled to a COVID-19-prevalent European country and was therefore treated as COVID-19 suspect. The day before, the patient sustained a burn to his left forearm after falling unconscious next to a radiator. A CT neck and thorax showed a parapharyngeal abscess, which was surgically drained, and the patient was discharged following an intensive care admission. He then developed mediastinitis 3 weeks post-discharge which required readmission and transfer to a cardiothoracic unit for surgical drainage. This report discusses the evolution of a deep neck space infection into a mediastinitis, a rare and life-threatening complication, despite early surgical drainage. This report also highlights the difficulties faced with managing patients during the COVID-19 pandemic.
一名50岁的白人男性在新冠疫情早期因面部迅速肿胀、发热、乏力和肌痛前往急诊科就诊。该患者近期去过一个新冠疫情流行的欧洲国家，因此被当作新冠疑似病例进行治疗。前一天，患者在散热器旁昏迷后左前臂被烧伤。颈部和胸部CT显示咽旁脓肿，进行了外科引流，患者在重症监护病房住院后出院。出院3周后，他又患上纵隔炎，需要再次入院并转至心胸外科进行手术引流。本报告讨论了尽管早期进行了外科引流，但深部颈部间隙感染演变为纵隔炎这一罕见且危及生命的并发症的过程。本报告还强调了在新冠疫情期间管理患者所面临的困难。
