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2019年7月7日星期日

Neck space infections (頸部間隙感染)

Acute retropharyngeal abscess (急性咽後膿腫)
Lymphadenitis of the retropharyngeal nodes following an upper respiratory tract infection in children.

Clinical features:
Presents with sore throat, pyrexia and swelling of the posterior pharyngeal wall. Lateral X-ray shows retropharyngeal swelling.

Management:
The abscess should be drained via the mouth with precautions taken to avoid inhalation of pus.


Chronic retropharyngeal abscess (慢性咽後膿腫)
Occurs in adults in association with tuberculous cervical spine disease.

Clinical features:
Swelling is seen in the midline of the pharynx and X-rays show vertebral disease.

Management:
Treatment is with antituberculous chemotherapy.


Parapharyngeal abscess (咽旁膿腫)
The tissue space lateral to the pharynx may become infected by spread of organisms from the tonsils or lower third molar teeth.

Clinical features:
Presents with sore throat and trismus. The tonsil is pushed medically and there is neck swelling.

Management:
Treatment is by incision and drainage via the neck followed by appropriate antibiotic therapy.


Ludwig’s angina (Ludwig咽峽炎)
Clinical features:
Cellulitis of the submandibular space secondary to dental disease or tonsillitis presents with swelling of the submental region and floor of the mouth.

Management:
Treat with high-dose antibiotics. 


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