頭頸部における重症深部感染症の2症例

Deep Serious Infection in Head and Neck:Report of Two Cases

　はじめに

　頭頸部深部の筋膜隙は互いに閉鎖しておらず，上方は頭蓋底に，下方は後部縦隔に連続している。このため，咽頭などの感染巣がこれらの筋膜隙に沿って膿瘍などを形成し，頭蓋底や縦隔へ進展することがある。

　今回われわれは，1）扁桃周囲膿瘍が深頸部，上縦隔へ進展して重篤な状態となった症例（下方進展例）と2）歯齪部の感染から側頭下窩膿瘍となった稀な症例（上方進展例）を経験したので報告する。

The first case had an upper-mediastinal abscess arising from peritonsillar abscess. The other had a deep abscess in the infratemporal fossa. They were treated by surgical drainage, intermittent flushing of the abscess cavity, administration of antibioticsand gamma globulin. Although their general condi-tions were poor at first, treatments were successful.

For the treatment of deep serious infection, administration of sensitive antibiotics against both aerobic and anaerobic bacterial infections is neces-sary. And if several images (CT, MRI etc.) reveal an abscess, surgical drainage is necessary as soon as possible. Careful follow-up of the general condition is also important, because severe and dangerous complications such as DIC or septic shock can be developed from severe infections.