Wong Chyau Hong, Chew Shiun Chuen
Hospital Sibu, 5 1/2KM, Jalan Oya, 96000 Sibu, Sarawak Malaysia.
Indian J Otolaryngol Head Neck Surg. 2024 Jun;76(3):2391-2403. doi: 10.1007/s12070-024-04475-4. Epub 2024 Jan 27.
This study is intended to explore the relationship of etiologies of neck space infection (NSI) and its prevalent microorganisms of NSI and to compare the treatments and its clinical outcomes with other studies. A retrospective study of 1 year duration from April 2022-April 2023 at ENT department Hospital Sibu includes total 40 NSI patients. 30 male and 10 female patients, with a male-to-female ratio of 3 were studied, with a mean age of 35.07 (± 18.25) years. Diabetes mellitus still constituted a high risk factor (27.3%), while patients with biohazard status (Hepatitis B and C) contributes 15.1%. There were 18 cases (45%) which etiology remained unknown, followed by odontogenic infection (27.5%), then upper respiratory tract infection (7.5%). 9 out of 40 patients required intensive care unit (ICU) care, with a median of 2.5 days ICU admission. Among the complications developed, airway obstruction (9 patients; 42.9%) was the most common. The most common infected neck space in our study was the submandibular space 18.1%; then the parapharyngeal space 13.3% and peritonsillar space 10.8%. The most common microorganism isolated was Streptococci Viridans (6 cases, 15%), followed by streptococcus pyogenes Group A (5 cases, 12.5%), then Klebsiella pneumoniae (4 cases, 10%). Interestingly, 62.5% of the neck infection cases were caused by single bacteria, while only 7.5% cases were infected by polymicrobial cause. Augmentin (amoxicillin and clavulanic acid) constitutes the highest proportion (40.4%) of first line antibiotics, while unasyn (ampicillin-sulbactam) was be a second substitute (13.5%). The duration of hospitalization ranged from 1 to 8 weeks, with a mean stay of 1.54 ± 1.49 weeks days. We achieved a high recovery rate of 97.5% with 1 patient died due to extensive small bowel ischemia.
本研究旨在探讨颈部间隙感染（NSI）的病因与其流行微生物之间的关系，并将其治疗方法及临床结果与其他研究进行比较。对2022年4月至2023年4月在诗巫医院耳鼻喉科进行的为期1年的回顾性研究，共纳入40例NSI患者。研究对象包括30例男性和10例女性患者，男女比例为3，平均年龄为35.07（±18.25）岁。糖尿病仍是一个高危因素（27.3%），而具有生物危害状态（乙型和丙型肝炎）的患者占15.1%。有18例（45%）病因不明，其次是牙源性感染（27.5%），然后是上呼吸道感染（7.5%）。40例患者中有9例需要重症监护病房（ICU）护理，ICU住院时间中位数为2.5天。在出现的并发症中，气道阻塞最为常见（9例患者；42.9%）。在我们的研究中，最常见的感染颈部间隙是下颌下间隙（18.1%）；其次是咽旁间隙（13.3%）和扁桃体周围间隙（10.8%）。分离出的最常见微生物是草绿色链球菌（6例，15%），其次是A组化脓性链球菌（5例，12.5%），然后是肺炎克雷伯菌（4例，1C%）。有趣的是，62.5%的颈部感染病例由单一细菌引起，而只有7.5%的病例是由多种微生物引起的感染。阿莫西林克拉维酸（Augmentin）构成一线抗生素的最高比例（40.4%），而氨苄西林舒巴坦（unasyn）是第二选择（13.5%）。住院时间为1至8周，平均住院时间为1.54±1.49周。我们实现了97.5%的高康复率，1例患者因广泛性小肠缺血死亡。
