[A case of cervico-mediastinal abscess, secondary to acute tonsillitis: investigation of the treatments].
No other infectious diseases in the field of otolaryngology cause rapid and lethal course than cervical abscess. A case of cervicomediastinal abscess secondary to acute tonsillitis was presented. The patient was a 43-year-old male with liver cirrhosis and primarily had the treatment of tonsillitis. The complication of duodenal perforation caused marked general deteriotation, and cervical abscess occured. Immediately after transfer to our department, he was treated by cervical drainage, laparotomy and chemotherapy. However, hepatic failure occured, and he died of sepsis on the 16th day after the onset of tonsillitis. Cervicomediastinal abscesses were classified according to severity in Stage 1-4. 34 cases of advanced cervical abscess were reported in Japan from 1976 to 1989. These cases were analyzed statistically in terms of primary focus of infection, surgical procedures, clinical isolates and chemotherapy, etc., and following results were obtained. 1) Primary focus; approximately 50% was due to the infection of the tonsills and the pharynx occupied about 50%, and the odontogenic infections, approximately 40%. 2) Surgical procedures; the neck doranaige approaching through the vertical incision resulted more effective. 3) Clinical isolates; aerobes and anaerobes accounted for 50% each of all strains. alpha-Streptococcus was predominant among aerobes, and Peptostreptococcus and Bacteroides were predominant among anaerobes. In order to confirm pathogenic bacteria of cervical abscess, clinical isolates of peritonsiller abscess and mandibular ostesis were compared with those of cervical abscess, because these infections are primary infectious diseases of cervical abscess.(ABSTRACT TRUNCATED AT 250 WORDS)
Fukamoto
K
K
Juntendo University, Urayasu Hospital, Tokyo.
Sugita
R
R
D000038:Abscess / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D000208:Acute Disease; D000328:Adult; D002981:Clindamycin / Q000627:therapeutic use; D004322:Drainage; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D009333:Neck; D014069:Tonsillitis / Q000150:complications*
D002981:Clindamycin