Tokuoka K, Hamano H, Ohta T, Tamura Y, Shinohara Y
Department of Neurology, Tokai University School of Medicine.
Rinsho Shinkeigaku. 1997 May;37(5):417-9.
Retropharyngeal and deep neck abscess, which may follow odontogenic infection, is uncommon in adults, but can be fatal. Furthermore, bacterial meningitis secondary to this disorder is extremely rare. A 67-year-old man was brought to our hospital because he had developed neck pain, trismus, and disturbance of consciousness over several days. A few days prior to the appearance of neck pain, he had the periodontitis treated. Based on CSF, cervical X-ray and CT findings, he was diagnosed as having bacterial meningitis secondary to deep neck abscess. Culture of the CSF yielded gram-positive cocci, later identified as Gemella species, that is a rare organism for bacterial meningitis. Although the administration of antibiotics and drainage of the abscess resulted in gradual improvement of the infectious process, neurologically he remained with apallic syndrome. We would like to stress the importance of odontogenic and pharyngolaryngogenic sources as potential foci of purulent meningitis.
咽后和颈部深部脓肿可能继发于牙源性感染，在成人中并不常见，但可能致命。此外，继发于这种疾病的细菌性脑膜炎极为罕见。一名67岁男性因数天来出现颈部疼痛、牙关紧闭和意识障碍被送至我院。在颈部疼痛出现前几天，他接受了牙周炎治疗。根据脑脊液、颈椎X线和CT检查结果，他被诊断为继发于颈部深部脓肿的细菌性脑膜炎。脑脊液培养出革兰氏阳性球菌，后来鉴定为孪生球菌属，这是细菌性脑膜炎中一种罕见的病原体。尽管使用抗生素和脓肿引流使感染过程逐渐改善，但在神经方面他仍处于植物状态。我们想强调牙源性和咽喉源性感染作为化脓性脑膜炎潜在病灶的重要性。
