小児の頸部膿瘍5症例

Five Cases of Neck Abscess in Children

　はじめに

　抗生物質の進歩により，最近では重篤な経過に至る深頸部感染症は減少したといわれている。しかし，糖尿病，膠原病，長期ステロイド使用，癌などの免疫能を低下させる基礎疾患を有する場合や，所見の取りにくい小児では急激な経過をたどり^1），ときに重症化する場合も有り得る。

　今回われわれは，切開排膿術を施行した小児の頸部膿瘍を1996年11月〜1999年10月の過去3年間に京都市立病院耳鼻咽喉科で5症例経験したので，若干の文献的考察を加えて報告する。

For the past three years, five cases of neck abscess in children have been treated in our hospital. In case 1, an 11-year-old female developed an abscess in the sub-mandibular space. In case 2, a 5-year-old male and in case 5, a 6-year-old male had an abscess due to infec-tion of pyriform sinus fistulae. In case 3, a 6-month-old male had retropharyngeal abscess and in case 4, an one-year-old female, had abscess in the nuchal area. We per-formed drainage in all cases. One of them underwent drainage under general anesthesia and the other four under local anesthesia. But, there was no complications in their operations. After drainage, we performed addi-tional treatment for dental caries in case 1, and exterpa-tion of pyriform sinus fistulae in case 2 and 5. Fre-quently children have vague complaints and no coopera-tion with examinations and treatments. Therefore ; if there were any suspicions of neck abscess, CT should be taken immediately, and treatments should be started in cooperation with pediatricians.