Vol.101 No.5 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 101 No. 5 May 2008
A Case of Deep Cervical and Mediastinal Abscess
Successfully Treated by Repeated Surgical Treatment
Kousuke Yoshifuku and Hiromi Nagano
(Ooshima Prefecture Hospital)
Yuichi Kurono
(Kagoshima University)
Deep neck infections including cervical abscess are severe and emergent diseases in otolaryngological practice. We encountered a 73-year-old male with a deep cervical and mediastinal abscess complicated by diabetes mellitus. ENT examination showed painful neck swelling with a severe bulge in the retropharyngeal space extending to the hypopharynx on the left side. CT examination indicated abscess formation with gas extending from the neck to the upper mediastium. We performed cervical drainage and administered intravenous antibiotics together with human immunoglobulin. Computed tomography (CT) on the next day showed persistent deep cervical and mediastinal abscess despite those treatments. During the second operation, cervical drainage was performed, but cervical and mediastinal abscess still persisted on CT. During the third operation, both cervical drainage and thoracoscopic drainage were performed in collaboration with thoracic surgeons. Then, the abscess disappeared completely within a few days after surgery.
We confirmed that immediate cervical drainage was essential for the treatment of deep cervical and mediastinal abscess. CT examination was considered the most useful evaluation for estimating the effect of treatment.
Key words :deep cervical and mediastinal abscess, Computed Tomograpy