Cases reported "Peritonsillar Abscess"

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1/4. Necrotizing fasciitis after peritonsillar abscess in an immunocompetent patient.

    Cervical necrotizing fasciitis (CNF) is a rapidly progressive, severe bacterial infection of the fascial planes of the head and neck. Group A beta haemolytic Streptococcus spp. (GABHS), staphylococcus spp., or obligatory anaerobic bacteria are the most common causative pathogens. The disease usually results from a dental source or facial trauma. Extensive fascial necrosis and severe systemic toxicity are common manifestations of CNF. review of the literature reveals only seven such cases, with four successful outcomes. The authors present the case of a 50-year-old immunocompetent female with CNF arising from a peritonsillar abscess. Intravenous immunoglobulins in conjunction with surgery and antibiotics were used successfully. The authors also suggest the importance of the early diagnosis, aggressive surgical debridement, broad-spectrum antibiotics, and possible usefulness of the intravenous immunoglobulins in the treatment of CNF, especially when the disease is associated with toxic shock syndrome.
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ranking = 1
keywords = bacterial infection
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2/4. Chron's disease, rare association with selective IgA immunodeficiency, and development of life-threatening bacterial infections.

    life-threatening necrotizing fasciitis and relapsing lemierre syndrome associated with fusobacterium necrophorum septicaemia occurred in young adults with a moderate Chron's disease and a missed profound iga deficiency. This unexpected association of a chronic bowel inflammatory syndrome with prominent IgA abnormalities and severe bacterial infection deserves careful attention by physicians faced with young patients with Chron's disease.
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ranking = 5
keywords = bacterial infection
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3/4. head and neck infections caused by streptococcus milleri group: an analysis of 17 cases.

    BACKGROUNDS: streptococcus milleri group (SMG) is a common inhabitant of the mouth and gastrointestinal tract, and can be an aggressive pathogen causing abscess formation at various sites in the body. However, it has rarely been listed as a cause of head and neck infections. OBJECTIVES: The present study was performed to evaluate the clinical significance of SMG by reviewing the microbiology and clinical records of patients with SMG in head and neck infections retrospectively. STUDY DESIGN: A retrospective review of all patients diagnosed as having SMG bacterial infections at Onomichi General Hospital, Hiroshima, between the years 2001 and 2002 was performed; 17 patients developed head and neck infections with SMG. Here, we describe the clinical features and management of SMG in head and neck infection. RESULTS: The patient population consisted of 12 males and 5 females with a median age of 62 years (age range, 8-78 years). The sites of infection were as follows: maxillary sinus (n=6), peritonsillar region (n=4), subcutaneous (n=3), submandibular space-retropharyngeal space (n=1), deep neck-mediastinum (n=1), parapharyngeal space (n=1), submandibular space (n=1), tonsil (n=1), parotid gland (n=1), and masseter muscle (n=1). Ten cases (59%) were of suppurative diseases. Six cases (35%) had mixed SMG with anaerobe infection. Three cases showed deteriorating clinical courses, and all three of these cases were culture-positive for SMG with anaerobes. In addition, one deteriorating case showed gas gangrene regardless of repeated surgical debridement and intravenous antibiotic therapy; hyperbaric oxygen therapy improved this patient's condition. CONCLUSION: It is important to recognize SMG as a pathogen in head and neck infection. In addition, the care should be taken with infectious diseases caused by SMG with anaerobes as the patient's clinical course can deteriorate rapidly.
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ranking = 1
keywords = bacterial infection
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4/4. Vascular complication of neck space infection: case report and literature review.

    Antibiotic therapy has changed the face of medicine radically, and physicians no longer have the empirical knowledge of bacterial infections that they once had. Consequently, the diagnosis and management of complicated infections presents a significant challenge to today's otolaryngologists. We present a rare complication, even before the advent of antibiotics, of a head and neck infection: a carotid artery pseudoaneurysm resulting from peritonsillar abscess. The diagnosis and management of this problem is discussed and the pertinent literature reviewed.
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ranking = 1
keywords = bacterial infection
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