BACKGROUND Kawasaki disease(KD),also known as mucocutaneous lymph node syndrome,is an acute,self-limiting vasculitis of unknown aetiology that mainly involves the medium and small arteries and can lead to serious card...BACKGROUND Kawasaki disease(KD),also known as mucocutaneous lymph node syndrome,is an acute,self-limiting vasculitis of unknown aetiology that mainly involves the medium and small arteries and can lead to serious cardiovascular complications,with a 25%incidence of coronary artery aneurysms.Periton–Sillar abscesses are a rare symptom of KD and is easily misdiagnosed at its early stages.CASE SUMMARY A 5-year-old boy who presented to a community hospital with a 3-d fever,difficulty in opening his mouth,and neck pain and was originally treated for throat infection without improvement.On the basis of laboratory tests,ultrasound of submandibular and superficial lymph nodes and computed tomography of the neck,the clinician diagnosed the periamygdala abscess and sepsis that did not resolve after antibiotic therapy.On the fifth day of admission,the child developed conjunctival congestion,prune tongue,perianal congestion and desquamation,and slightly stiff and swollen bunions on both feet.A diagnosis of KD was reached with complete remission after intravenous immunoglobulin treatment.CONCLUSION Children with neck pain,lymph node enlargement,or airway obstruction as the main manifestations are poorly treated with intravenous broad-spectrum antibiotics.Clinicians should not rush invasive operations such as neck puncture,incision,and drainage and should be alert for KD when it cannot be explained by deep neck space infection and early treatment with aspirin combined with gammaglobulin.展开更多
Pediatric ear,nose,and throat(ENT)infections are common and vary from simple to life-threatening cases,including complicated sinusitis,deep neck space abscesses,and mastoiditis.ENT infections in children are a primary...Pediatric ear,nose,and throat(ENT)infections are common and vary from simple to life-threatening cases,including complicated sinusitis,deep neck space abscesses,and mastoiditis.ENT infections in children are a primary driver of antibiotic prescriptions.1 While invasive surgical cultures often yield successful pathogen identification,they require anesthesia and inpatient care.Patients are prescribed broad-spectrum antibiotics until the culture results become available.展开更多
Objectives:To compare the effectiveness of vacuum-assisted closure(VAC)against traditional drainage technique,using a retrospective case-control study design,in terms of managing deep neck infections(DNIs).Methods:Pat...Objectives:To compare the effectiveness of vacuum-assisted closure(VAC)against traditional drainage technique,using a retrospective case-control study design,in terms of managing deep neck infections(DNIs).Methods:Patients presenting to Peking Union Medical College Hospital diagnosed with DNIs were recruited in this study.We analyzed the clinical characteristics of DNI patients and divided them into(a)VAC placement group(26 cases)and(b)traditional drainage group(57 cases)according to whether VAC was placed.The differences in length of stay(LOS),wound healing time,and debridement frequency were compared between the two groups.Results:Eighty-three patients had multiple-space infections,i.e.infection at two or more sites.The debridement frequency of the VAC group was significantly lower than that of the traditional drainage group(p=0.001).The wound healing time of the traditional drainage group and VAC group was 38 days(a range of 13-98 days)and 40 days(a range of 11-106 days),respectively;the average LOS was 15 days(a range of 2-68 days)and 16 days(a range of 4-35 days),respectively;and the debridement frequencies were one time(a range of 0-3 times)and zero times(a range of 0-2 times),respectively.The two groups did not differ significantly in wound healing time and hospitalization duration(p=0.319 and 0.937).Conclusions:VAC treatment of DNIs has significant advantages in reducing the frequency of debridement and patient suffering,but it does not show significant advantages in wound healing.Randomized trials are still needed to demonstrate its efficacy.展开更多
Objective:To review the clinical findings in deep neck infections and identification predisposing factors of these complications. Methods:In this study, 270 patients with deep neck infections were studied retrospectiv...Objective:To review the clinical findings in deep neck infections and identification predisposing factors of these complications. Methods:In this study, 270 patients with deep neck infections were studied retrospectively, study conducted in the Department of Ear, Nose and Throat, Dr. Shankarrao Chavan Govern-ment Medical College, Nanded, Maharashtra, India, from March 2013 to March 2016. Results:Analysis showed that males are most likely to have deep neck space infections (DNSI). Odontogenic and tonsillar causes were the more frequent ones. Staphylococcus aureus and Streptococcus species were the microorganisms more commonly isolated. Conclusion:DNSI remains a common and challenging disease for otorhinolaryngologists, and should be treated on emergency basis. In developing countries, lack of adequate nutrition, poor oral hygiene, tobacco chewing, smoking and beetle nut chewing has led to an increased prevalence of dental and periodontal diseases. In present study, Odontogenic infections were the most common etiological factor for DNSI.展开更多
文摘BACKGROUND Kawasaki disease(KD),also known as mucocutaneous lymph node syndrome,is an acute,self-limiting vasculitis of unknown aetiology that mainly involves the medium and small arteries and can lead to serious cardiovascular complications,with a 25%incidence of coronary artery aneurysms.Periton–Sillar abscesses are a rare symptom of KD and is easily misdiagnosed at its early stages.CASE SUMMARY A 5-year-old boy who presented to a community hospital with a 3-d fever,difficulty in opening his mouth,and neck pain and was originally treated for throat infection without improvement.On the basis of laboratory tests,ultrasound of submandibular and superficial lymph nodes and computed tomography of the neck,the clinician diagnosed the periamygdala abscess and sepsis that did not resolve after antibiotic therapy.On the fifth day of admission,the child developed conjunctival congestion,prune tongue,perianal congestion and desquamation,and slightly stiff and swollen bunions on both feet.A diagnosis of KD was reached with complete remission after intravenous immunoglobulin treatment.CONCLUSION Children with neck pain,lymph node enlargement,or airway obstruction as the main manifestations are poorly treated with intravenous broad-spectrum antibiotics.Clinicians should not rush invasive operations such as neck puncture,incision,and drainage and should be alert for KD when it cannot be explained by deep neck space infection and early treatment with aspirin combined with gammaglobulin.
文摘Pediatric ear,nose,and throat(ENT)infections are common and vary from simple to life-threatening cases,including complicated sinusitis,deep neck space abscesses,and mastoiditis.ENT infections in children are a primary driver of antibiotic prescriptions.1 While invasive surgical cultures often yield successful pathogen identification,they require anesthesia and inpatient care.Patients are prescribed broad-spectrum antibiotics until the culture results become available.
基金Natural Science Foundation of Beijing Municipality(Grant/Award Number:7192171)Peking Union Medical Foundation,Pumch Healthcare Quality and Safety Incubation Program(Grant/Award Number:XHZJ2411)。
文摘Objectives:To compare the effectiveness of vacuum-assisted closure(VAC)against traditional drainage technique,using a retrospective case-control study design,in terms of managing deep neck infections(DNIs).Methods:Patients presenting to Peking Union Medical College Hospital diagnosed with DNIs were recruited in this study.We analyzed the clinical characteristics of DNI patients and divided them into(a)VAC placement group(26 cases)and(b)traditional drainage group(57 cases)according to whether VAC was placed.The differences in length of stay(LOS),wound healing time,and debridement frequency were compared between the two groups.Results:Eighty-three patients had multiple-space infections,i.e.infection at two or more sites.The debridement frequency of the VAC group was significantly lower than that of the traditional drainage group(p=0.001).The wound healing time of the traditional drainage group and VAC group was 38 days(a range of 13-98 days)and 40 days(a range of 11-106 days),respectively;the average LOS was 15 days(a range of 2-68 days)and 16 days(a range of 4-35 days),respectively;and the debridement frequencies were one time(a range of 0-3 times)and zero times(a range of 0-2 times),respectively.The two groups did not differ significantly in wound healing time and hospitalization duration(p=0.319 and 0.937).Conclusions:VAC treatment of DNIs has significant advantages in reducing the frequency of debridement and patient suffering,but it does not show significant advantages in wound healing.Randomized trials are still needed to demonstrate its efficacy.
文摘Objective:To review the clinical findings in deep neck infections and identification predisposing factors of these complications. Methods:In this study, 270 patients with deep neck infections were studied retrospectively, study conducted in the Department of Ear, Nose and Throat, Dr. Shankarrao Chavan Govern-ment Medical College, Nanded, Maharashtra, India, from March 2013 to March 2016. Results:Analysis showed that males are most likely to have deep neck space infections (DNSI). Odontogenic and tonsillar causes were the more frequent ones. Staphylococcus aureus and Streptococcus species were the microorganisms more commonly isolated. Conclusion:DNSI remains a common and challenging disease for otorhinolaryngologists, and should be treated on emergency basis. In developing countries, lack of adequate nutrition, poor oral hygiene, tobacco chewing, smoking and beetle nut chewing has led to an increased prevalence of dental and periodontal diseases. In present study, Odontogenic infections were the most common etiological factor for DNSI.
