2018-19 Section 7-Neoplastic and Inflammatory Diseases of the Head and Neck eBook

Eur Arch Otorhinolaryngol (2012) 269:1241–1249

6. Boscolo-Rizzo P, Da Mosto MC (2009) Submandibular space infection: a potentially lethal infection. Int J Infect Dis 13:327–333 7. Brook I (2007) The role of anaerobic bacteria in upper respiratory tract and other head and neck infections. Curr Infect Dis Rep 9:208–217 8. Leibovici L, Yehezkelli Y, Porter A (1996) Influence of diabetes mellitus and glycaemic control on the characteristics and out- come of common infections. Diabetic Med 13:457–463 9. Slovenkai MP (1998) Foot problems in diabetes. Med Clin North Am 82:949–971 10. Lassmann B, Gustafson DR, Wood CM et al (2007) Reemergence of anaerobic bacteremia. Clin Infect Dis 44:895–900 11. Brook I (2010) b -Lactamase-producing bacteria in upper respi- ratory tract infections. Curr Infect Dis Rep 12:110–117 12. Moran GJ, Krishnadasan A, Gorwitz RJ et al (2006) Methicillin- resistant S. aureus infections among patients in the emergency department. N Engl J Med 355:666–674 13. Popovich KJ, Weinstein RA, Hota B (2008) Are community- associated methicillin-resistant Staphylococcus aureus (MRSA) strains replacing traditional nosocomial MRSA strains? Clin Infect Dis 46:787–794 14. Nagy M, Backstrom J (1999) Comparison of the sensitivity of lateral neck radiographs and computed tomography scanning in pediatric deep-neck infections. Laryngoscope 109:775–779 15. Boscolo-Rizzo P, Marchiori C, Zanetti F et al (2006) Conserva- tive management of deep neck abscesses in adults: the impor- tance of CECT findings. Otolaryngol Head Neck Surg 135:894–899 16. Elden LM, Grundfast KM, Vezina G (2001) Accuracy and use- fulness of radiographic assessment of cervical neck infections in children. J Otolaryngol 30:82–89 17. Wang LF, Tai CF, Kuo WR et al (2010) Predisposing factors of complicated deep neck infections: 12-year experience at a single institution. J Otolaryngol Head Neck Surg 39:335–341 18. Smith JL, Hsu JM, Chang J (2006) Predicting deep neck space abscess using computed tomography. Am J Otolaryngol 27:244–247 19. Kirse DJ, Roberson DW (2001) Surgical management of retro- pharyngeal space infections in children. Laryngoscope 111:1413–1422 20. Gahleitner A, Watzek G, Imhof H (2003) Dental CT: imaging technique, anatomy, and pathologic conditions of the jaws. Eur Radiol 13:366–376 21. Giyanani VL, Mirfakhraee M, Gerlock AJ et al (1985) Computed tomography of internal jugular thrombosis. J Comput Assist Tomogr 9:33–37 22. Ridder GJ, Maier W, Kinzer S et al (2010) Descending necro- tizing mediastinitis: contemporary trends in etiology, diagnosis, management, and outcome. Ann Surg 251:528–534 23. Allan AG (2004) Reluctance of anaesthetists to perform awake intubation. Anaesthesia 59:413 24. Boyanova L, Kolarov R, Mitov I (2007) Antimicrobial resistance and the management of anaerobic infections. Expert Rev Anti Infect Ther 5:685–701 25. Sichel JY, Dano I, Hocwald E et al (2002) Non surgical man- agement of parapharyngeal space infections: a prospective study. Laryngoscope 112:906–910 26. Boscolo Rizzo P, Scotton PG, Da Mosto MC et al (2003) Sin- drome di Lemierre da Streptococcus constellatus. Caso clinico e rassegna della letteratura. Giorn It Mal Inf 9:167–170 27. Syed MI, Baring D, Addidle M et al (2007) Lemierre syndrome: two cases and a review. Laryngoscope 117:1605–1610

pathogenesis of this disease is the internal jugular vein thrombophlebitis. Septic metastases may occur and fre- quently affect the lungs. Clinically, the onset of septic symptoms often coincides with the end of oropharyngeal symptoms. Septic fever, tension of the sternocleidomastoid muscle and a stiff neck are the most frequent symptoms plus those connected with the site of the secondary local- izations (chest pain, dyspnea, hemoptysis, and more uncommonly joint pains, abdominal pain with possible acute abdomen) [ 26 ]. Broad-spectrum therapy should be given for more than 3 weeks. On the other hand, the role of anticoagulation has remained controversial [ 27 ]. Ligation and resection of the internal jugular vein, which was fre- quent in the pre-antibiotic era, is now recommended by some authors only in the case of persistent sepsis with embolism. The availability of effective antibiotics and improved oral hygiene have dramatically modified the epidemiology of DNIs making them less common today than in the past. However, even in this era of antibiotic therapy and modern imaging techniques, DNIs remain a constant challenge. Airway obstruction and descending mediastinitis are the most troublesome complications of DNIs. In selected patients, a trial of intravenous targeted or broad-spectrum empiric antibiotic therapy associated with an intensive CECT-based wait-and-watch policy may avoid an unnec- essary surgical procedure. However, about one-fourth of patients present significant comorbidities, which may negatively affect the course of the infection. In these cases and in patients with large or multiple spaces infections, a more aggressive surgical strategy is mandatory. Conclusion

Conflict of interest

There are no potential conflicts of interest.

References

1. Daramola OO, Flanagan CE, Maisel RH et al (2009) Diagnosis and treatment of deep neck space abscesses. Otolaryngol Head Neck Surg 141:123–130 2. Reynolds SC, Chow AW (2007) Life-threatening infections of the peripharyngeal and deep fascial spaces of the head and neck. Infect Dis Clin North Am 21:557–576 3. Brook I (2004) Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses. J Oral Maxillofac Surg 62:1545–1550 4. Levitt GW (1970) Cervical fascia and deep neck infections. Laryngoscope 80:409–435 5. Lin HT, Tsai CS, Chen YL et al (2006) Influence of diabetes mellitus on deep neck infection. J Laryngol Otol 120:650–654

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