Yankov Yanko G, Stoev Lyuben L, Stoeva Martina G, Stoev Alexandar L, Mechkarova Iliana D, Nenova Diana D
Clinic of Maxillofacial Surgery, University Hospital "St. Marina", Varna, BGR.
Department of General and Operative Surgery, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, BGR.
Cureus. 2025 Aug 12;17(8):e89951. doi: 10.7759/cureus.89951. eCollection 2025 Aug.
Introduction Purulent inflammatory diseases of the head and neck represent the most common pathology within the domain of oral and maxillofacial surgery that necessitates hospitalization and urgent surgical intervention. A considerable proportion of these cases involve inflammation of the cervical lymph nodes. If not treated promptly, such infections can lead to prolonged hospital stays, including admission to intensive care units, impose a significant burden on healthcare systems, and result in severe complications, including death. Materials and methods This original study is a retrospective analysis conducted over an eight-year period (2015-2022), involving 26 adult patients (14 men and 12 women) diagnosed with purulent inflammation of the cervical lymph nodes who underwent emergency incision and drainage. In all cases, biological specimens were collected intraoperatively for microbiological analysis. The obtained results were processed and analyzed in the present work. Results The mean patient age was 49 years (range 23-81), with an average of 43 years (range 23-72) in men and 55 years (range 29-81) in women. Microorganisms were isolated in 23 of 26 patients. The most frequently identified pathogen was (n = 15), followed by resident oral microflora (n = 4), (n = 2), (n = 1), and (n = 1). In three patients, no microorganisms were detected (sterile cultures). Conclusions Our study, although single-center, confirms that in cases of purulent cervical lymphadenitis within the scope of oral and maxillofacial surgery, empirical antimicrobial therapy should be selected to provide coverage for both Gram-positive and Gram-negative organisms. Clinicians should also be aware that, although uncommon, fungal pathogens may be encountered.
引言 头颈部化脓性炎症性疾病是口腔颌面外科领域最常见的病理情况,需要住院治疗并进行紧急手术干预。这些病例中有相当一部分涉及颈部淋巴结炎症。如果不及时治疗,此类感染可能导致住院时间延长,包括入住重症监护病房,给医疗系统带来巨大负担,并导致严重并发症,包括死亡。
材料与方法 本原创性研究是一项为期八年(2015 - 2022年)的回顾性分析,涉及26例诊断为颈部淋巴结化脓性炎症并接受紧急切开引流的成年患者(14名男性和12名女性)。所有病例均在术中采集生物标本进行微生物学分析。在本研究中对获得的结果进行了处理和分析。
结果 患者的平均年龄为49岁(范围23 - 81岁),男性平均年龄为43岁(范围23 - 72岁),女性为55岁(范围29 - 81岁)。26例患者中有23例分离出微生物。最常鉴定出的病原体是[此处原文缺失具体病原体名称](n = 15),其次是口腔常驻微生物群(n = 4),[此处原文缺失具体病原体名称](n = 2),[此处原文缺失具体病原体名称](n = 1),以及[此处原文缺失具体病原体名称](n = 1)。3例患者未检测到微生物(无菌培养)。
结论 我们的研究虽然是单中心研究,但证实了在口腔颌面外科范围内的化脓性颈淋巴结炎病例中,应选择经验性抗菌治疗以覆盖革兰氏阳性和革兰氏阴性菌。临床医生还应意识到,虽然真菌病原体不常见,但可能会遇到。