A Case of Gas Gangrene in the Neck

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  • Kimura Miwako
    Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo Hospital Department of Otolaryngology, Takeda General Hospital
  • Hagisawa Miho
    Department of Neurotology, Tokyo Metropolitan Neurological Hospital
  • Nakashima Masato
    Department of Otolaryngology, Takeda General Hospital
  • Nito Takaharu
    Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo Hospital
  • Tayama Niro
    Department of Otolaryngology, Head and Neck Surgery, The University of Tokyo Hospital Department of Otolaryngology, Tracheo-esophagology, International Medical Center of Japan

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Other Title
  • う歯から生じた頚部ガス壊その１症例
  • 症例報告 齲歯から生じた頸部ガス壊疽の1症例
  • ショウレイホウコク ウシ カラ ショウジタ ケイブ ガス エソ ノ 1 ショウレイ

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Abstract

Gas gangrene in the neck is a rare but life-threatening infection that easily progresses to mediastinitis and damages vital organs in the chest. A 51-year-old female was referred to our hospital because of aggressive neck pain and dyspnea. Neck and chest CT demonstrated bilateral abscesses in the neck that appeared to be spreading to the mediastinum with the image of an air bubble. Under a diagnosis of gas-producing abscesses, administration of antibiotics as well as gamma-globulin for two weeks was followed by emergency surgical treatment. After tracheotomy to maintain the airway under local anesthesia, we performed mediastinal drainage by transcervical and external approaches to the neck abscesses which involved multiple spaces. In this case, anaerobic bacteria and Streptococcus spp. were detected in the necrotic tissues. These findings suggest that prompt surgical treatment and adequate chemotherapy are indispensable to saving the patient's life in cases of gas gangrene in the neck.

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