Alosaimi Abdulrahman, Banjar Murad A, Felemban Walaa A, Abulnassr Khalid A, Sabbagh Yasser A
Department of Otolaryngology-Head and Neck Surgery, Ohud Hospital, Madinah, SAU.
College of Medicine, Rayan Medical College, Madinah, SAU.
Cureus. 2025 Jan 30;17(1):e78244. doi: 10.7759/cureus.78244. eCollection 2025 Jan.
Necrotizing infections of the head and neck are uncommon, aggressive, and potentially fatal if not treated promptly. These infections are particularly prevalent among immunocompromised individuals, such as people with diabetes, due to impaired immune response and delayed healing. We present a 45-year-old male with uncontrolled diabetes who had a five-day history of progressive left-sided neck swelling and pain. Imaging studies revealed an extensive necrotizing infection of the submandibular, parotid, and parapharyngeal carotid spaces. The condition was managed with intravenous antibiotics, ultrasound-guided aspiration, surgical drainage, extensive debridement, and skin grafting. The isolated microorganism was Klebsiella pneumoniae. After three weeks of management, the patient was discharged without impairment or recurrence. This case underscores the significance of early diagnosis, proper antibiotic use, timely surgery, and collaboration in managing neck space necrotizing infections to prevent complications in high-risk patients.
头颈部坏死性感染并不常见，具有侵袭性，若不及时治疗可能致命。由于免疫反应受损和愈合延迟，这些感染在免疫功能低下的个体中尤为普遍，如糖尿病患者。我们报告一名45岁男性，患有未控制的糖尿病，有左侧颈部进行性肿胀和疼痛5天的病史。影像学检查显示下颌下、腮腺和咽旁颈动脉间隙广泛坏死性感染。通过静脉注射抗生素、超声引导下抽吸、手术引流、广泛清创和皮肤移植进行治疗。分离出的微生物是肺炎克雷伯菌。经过三周的治疗，患者出院时无功能障碍或复发。该病例强调了早期诊断、合理使用抗生素、及时手术以及在管理颈部间隙坏死性感染以预防高危患者并发症方面进行协作的重要性。
