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本文报告4例致命性颈部蜂窝织炎病例,结合文献复习,讨论了各菌种所致颈部感染的特征及其处理原则。例1.为 B 型流感嗜血杆菌(HIB)感染,女,58岁。咽痛、颈前部红肿拟诊会厌炎、肺炎入院。虽经抗生素治疗,病情仍加重,入院后12小时气道阻塞作了气管切开,颈部手术引流有粉红色水肿液渗出,无组织坏死或脓肿。第3日发生呼吸衰竭、肾功能衰竭、DIC (弥漫性血管内凝血)。第4日死亡。尸检有融合性肺炎、肺水肿、肝坏死。颈部未解剖。例2.β-溶血性链球菌感染,女,78岁。因风湿性关节痛入院,发生左耳道肿痛,继左侧面颊、颈部肿胀,估计为腮腺炎波及咽旁间隙。在
This article reports 4 cases of fatal cervical cellulitis, combined with the literature review, discusses the characteristics of the various strains of cervical infections and treatment principles. Example 1. Infection with Haemophilus influenzae type B (HIB), female, 58 years old. Sore throat, neck anterior inflamed migraine will be diagnosed, pneumonia admission. Although antibiotic treatment, the condition is still aggravating, airway obstruction was tracheotomy 12 hours after admission, neck drainage of pink edema effusion, no tissue necrosis or abscess. Respiratory failure on the third day, renal failure, DIC (disseminated intravascular coagulation). Day 4 death. Autopsy of a merger pneumonia, pulmonary edema, liver necrosis. The neck is not dissected. Example 2. β-hemolytic streptococcal infection, female, 78 years old. Due to rheumatoid arthralgia admitted to the left ear canal swelling and pain, following the left cheek, neck swelling, estimated to be affected parotid parapharyngeal space. in