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はじめに
副咽頭間隙膿瘍は近年の画像診断の進歩によって迅速な診断が可能となり,優れた抗生物質により重篤化する症例は減少している。しかし,依然として周囲への炎症波及や全身的合併症により,致命的経過をたどる症例も報告されており1,2),楽観できない疾患の1つであることに変わりはない。今回われわれは,敗血症から播種性血管内凝固症候群(DIC),さらには成人呼吸促迫症候群(ARDS)を併発した副咽頭間隙膿瘍の1症例を経験したので,その臨床経過と若干の文献的考察を加え報告する。
A parapharyngeal abscess was developed in a 61-year-old man, and the abscess located superiorly at the level of the styloid process, inferiorly at the level of the cricoid cartilage. Immediate after inci-sion under general anesthesia, pus was drained, washed out and the wound was kept open. Postope-ratively, respiratory condition revealed diffusion disturbance pattern with hypoxemia and he was diagnosed as adult respiratory distress syndrome and DIC due to bacteremia. Streptococcus constel-latus was positive both in preoperative arterial blood culture and culture from the pus. Systemic treatments under a respirator dramatically im-proved systemic condition without sequelae.
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