Neck swelling from a retropharyngeal abscess caused by penicillin-resistant Streptococcus pneumoniae: a case report.
Neck swelling from a retropharyngeal abscess caused by penicillin-resistant Streptococcus pneumoniae: a case report.
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DOI：
10.1186/1756-0500-7-291
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发表时间：
2014-05-10
影响因子：
1.8
通讯作者：
Harada T
中科院分区：
文献类型：
--
作者：
Hyo Y;Fukushima H;Harada T
在小孩子中，咽后脓肿通常发生在上呼吸道感染之后。与成人不同的是，这些囊肿在幼儿中很难诊断，并且可以迅速发展为深颈部或纵隔囊肿。一名2岁的日本男孩最近来我科就诊，主诉颈部肿胀。体格检查发现双侧扁桃体炎和左咽后壁肿胀。急诊颈部计算机断层扫描血管造影显示左咽后间隙后方有一个造影剂增强的脓肿腔，颈部后方有一个低密度区，周围有一个无造影剂增强的区域。后者被怀疑是一个深颈部感染继发于咽后脓肿。手术后，患者被诊断为咽后脓肿和并发囊性淋巴管瘤。经口内切开引流及抗生素治疗后，病变好转。淋巴管瘤和咽后淋巴管瘤在儿童中比在成人中更常见。然而，我们在文献中并未发现淋巴管瘤与咽后脓疡同时出现的报告。
In small children, retropharyngeal abscesses usually occur after upper respiratory tract infections. Unlike in adults, these abscesses are difficult to diagnose in small children, and can rapidly develop into deep neck or mediastinal abscesses. A 2-year-old Japanese boy recently presented to our department with a chief complaint of neck swelling. Physical examination revealed bilateral tonsillitis and swelling of the left posterior pharyngeal wall. Emergency neck computed tomography angiography showed a contrast-enhanced abscess cavity posterior to the left retropharyngeal space, and a low-density area surrounded by an area without contrast enhancement in the posterior neck. The latter was suspected to be a deep neck infection secondary to a retropharyngeal abscess. After surgery, the patient was diagnosed with a retropharyngeal abscess and concurrent cystic lymphangioma. The lesions improved after intraoral incision and drainage, and administration of antibiotics. Lymphangiomas and retropharyngeal abscesses are both known to be more common in children than in adults. However, we found no other reports of concomitant presentation of lymphangioma and retropharyngeal abscess in the literature.