• Clinical and Experimental Pediatrics
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• v.53 no.9
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• pp.855-858
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• 2010

Kawasaki disease (KD) causes multisystemic vasculitis but infrequently manifests with deep neck infections, such as a peritonsillar abscess, peritonsillar or deep neck cellulitis, suppurative parapharyngeal infection, or retropharyngeal abscess. As its etiology is still unknown, the diagnosis is usually made based on typical symptoms. The differential diagnosis between KD and deep neck infections is important, considering the variable head and neck manifestations of KD. There are several reports on KD patients who were initially diagnosed with retropharyngeal abscess on on computed tomography scans (CT). However, the previously reported cases did not have abscess or fluid collection on retropharyngeal aspiration. Therefore, false-positive neck CT scans have been obtained, until recently. In this case, suspected neck abscess in patients with KD unresponsive to intravenous immunoglobulin could signal the possible coexistence of suppurative cervical lymphadenitis.

• Korean Journal of Bronchoesophagology
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• v.16 no.2
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• pp.115-120
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• 2010

Background: Pediatric deep neck infection can cause critical complications in that they are seldom able to verbalize symptoms or cooperate with physical examination. The objective of this study is to identify the clinical characteristics according to age. Material and Method: A retrospective study was performed on 26 cases with pediatric deep neck infection during 12 years. Patients were classified infancy group (1-7 yr, 19.2%), preschool age group (7-15 yr, 30.8%) and school age group (15 yr-, 50%). We analyzed the age, sex, sites of abscess, predisposing factors, symptoms and compared onset, hospital date, laboratory and outcomes at each group. Results: In pediatric patients with deep neck infection, the age distribution was 18 males (69.2%) and 8 females (30.8%), the mean age was 7.4 years. The most common infection site was the anterior cervical triangle and submandibular space (19.2%). The most commonly known associated preceding disease was upper viral infection (34.6%), but we could not find the preceding diseases in most of cases (50%). Neck swelling (69.2%) was the most frequent symptom. The mean age of patients who performed neck CT was 8.23 years and neck US was 2.75 years. The younger patients were preferred to perform the neck US than the neck CT (p=0.022). The mean time from disease onset to admission was 9 days in the infancy, 5.5 days in the preschool aged and 5 days in the school aged group. The surgical treatment was performed in 30.8% of school aged, 62.5% of preschool aged and 100% of infancy group. Surgical treatment was preferred to younger patients (p=0.026). Conclusion: Abscess sites, size, and antibiotics susceptibility and especially patient age should be carefully considered in treating pediatric deep neck infection.

• Korean Journal of Head & Neck Oncology
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• v.35 no.2
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• pp.31-34
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• 2019

Lemierre's syndrome is rare disease characterized by anaerobic sepsis, internal jugular vein thrombosis, septic emboli that resulted from head and neck infection. Lemierre's syndrome has significant morbidity, so immediate, accurate diagnosis and treatment is needed. It is necessary to perform contrast-enhanced computed tomography (CT) for diagnosis. Systemic antibiotics is recommended, and surgical interventions, anticoagulation may beis considered for treatment. We report misdiagnosed case as a simple deep neck infection on initial ultrasonography with simultaneous abscess aspiration but finally diagnosed and treated internal jugular vein thrombophlebitis (Lemierre's syndrome) on CT scan. We report a case of a 45-year-old patient, who was diagnosed with a simple deep neck infection and treated with simultaneous abscess aspiration, but finally diagnosed and treated internal jugular vein thrombophlebitis (Lemierre's syndrome) on CT scan.

• Korean Journal of Bronchoesophagology
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• v.9 no.2
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• pp.49-55
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• 2003

Background and Objectives : Traditionally incision and drainage is considered to be standard treatment of deep neck infection. But antibiotics and diagnostic technique are developed recently, there are reports that conservative therapy could be as successful as open surgical drainage. The purposes of this study has been to assess clinical feature between surgical therapy group and conservative therapy group through statistical analysis. Materials and Methods : A retrospective study was performed on 46 cases of deep neck space abscess, which were confirmed CT, in patients admitted from January 1999 to June 2002. Result : About 80% of all are treated with conservative therapy. Erythrocyte sediment rate, volume of abscess and duration of hospitalization of conservative therapy group are decreased than those of surgical therapy group. Conclusions : Conservative therapy is expected to be effective on treatment of early stage, small sized deep neck infection. But its complication can lead to serious condition of patient it should be done under meticulous observation.

• Korean Journal of Bronchoesophagology
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• v.11 no.1
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• pp.37-41
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• 2005

Deep neck infections mean infection in the potential spaces and facial planes of the neck, either abscess formation or cellulitis. Deep neck infections are caused by dental, salivary gland, pharyngeal and tonsillar infections. Sometimes, deep neck infection may be caused by tuberculosis in case of immunodefiecient patients. Acquired immunodeficiency syndrome(AIDS) is a disease associated with defective cell-mediated immunity after infected with human immunodeficiency virus(HIV). The chance of opportunistic infection in patients of AIDS increases as the level of immunodeficienty progresses. Human immunodeficiency virus infection is the most single significant risk factor for progression of pulmonary tuberculosis to extrapulmonary sites. In patients infected with HIV, the rate of extrapulomonary tuberculosis rises upto $60\%$. We report a case of a 47 year old male patient with AIDS associated with deep neck infection by tuberculosis.

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.182-186
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• 2010

Purpose: Intramuscular stimulation (IMS) shows good results in the treatment of chronic pain patients who did not respond to other treatments such as oral analgesics, trigger point injection, nerve block and epidural steroid injection. But, IMS procedure especially, patients with diabetes mellitus (DM) has sometimes serious problem. So, we present a very rare case of intramuscular abscess in the sternocleiomastoid muscle after IMS with literature review. Methods: A 66 year old male visited our department 7 days after IMS in the neck. His premorbid conditions and risk factors of deep neck infection was DM and old age. Computed tomographic scans of the head and neck region were performed in this patient: signs of deep neck infection, were seen enhanced abscess in the sternocleidomastoid muscle, cellulitis overlying tissue of the neck, and air bubbles involved muscle. Necrotic wound was excised serially and we treated this with the Vacuum-assisted closure (VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, drainage of the abscess with the VAC system, and then primary closure. The postoperative course was uneventful. Results: We suggest that many of the infectious complications may be preventable by strict adherence to aseptic techniques and that some of the other complications may be minimized by refining the techniques with a clear understanding of the medical disorders of patients. And, the refined technique using the VAC system can provide a means of simple and effective management for the cervical intramuscular abscess, with better cosmetic and functional results.

• Korean Journal of Bronchoesophagology
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• v.12 no.2
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• pp.42-46
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• 2006

Descending necrotizing mediastinitis (DNM) is defined as mediastinal infection that begins at the cervical region and spread through deep fascial planes into the mediastinum. This is a rare and life-threatening complication of deep neck space infection. As infection reaches the mediastinum, widespread cellulitis, necrosis, abscess formation and sepsis may occur. So, early diagnosis and immediate antibiotics and surgical treatment are required to improve the poor prognosis of DNM. We present four cases of deep neck infection causing a virulent mediastinitis with a literature review.

• Korean Journal of Bronchoesophagology
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• v.14 no.1
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• pp.38-41
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• 2008

Deep neck infection is an infection in the potential spaces and fascial planes of the neck, either with abscess formation or cellulitis. In the preantibiotics era most cases of deep neck infection were secondary to an oropharyngeal infection. Moreover, today manupulation of intubation tube and gastroenteroscopy may cause deep neck infection by iatrogenic trauma. We experience 1 case of deep neck infection which originate from pharyngeal penetrating injury following gastroenteroscopy.

• Imaging Science in Dentistry
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• v.41 no.4
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• pp.189-193
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• 2011

The advent and wide use of antibiotics have decreased the incidence of deep neck infection. When a deep neck infection does occur, however, it can be the cause of significant morbidity and death, resulting in airway obstruction, mediastinitis, pericarditis, epidural abscesses, and major vessel erosion. In our clinic, a patient with diffuse chronic osteomyelitis of mandible and fascial space abscess and necrotic fasciitis due to odontogenic infection at the time of first visit came. We successfully treated the patient by early diagnosis using contrast-enhanced CT and follow up dressing through the appropriate use of radiographic images.

• Korean Journal of Bronchoesophagology
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• v.14 no.2
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• pp.57-63
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• 2008

Hypopharyngeal perforation secondary to tracheal intubation is rare, but may result in severe airway complications that include retropharyngeal abscess, pneumothorax, pneumonia, mediastinitis and death. The most common site of hypopharyngeal perforation is the pyriform sinus and the region of the cricopharyngeus muscle. We report a 62-year old man with intubation-induced hypopharyngeal injury presenting as deep neck infection. The patient presented with dyspnea and pain on the neck. Neck CT scan identified fluid and air collection on the neck from the hyoid bone to the thoracic inlet level. Despite of delayed diagnosis, we successfully operated him by using strap muscle myofascial transposition flap. The patient was followed up for 3 months without any complications.