Abstract
Phlegmon of the neck complicated by acute respiratory failure
Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu
Klinika Otolaryngologii i Onkologii Laryngologicznej, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu
Deep neck abscess is a serious, potentially life-threatening infection of the deep neck tissues, most commonly resulting from oral or pharyngeal infections such as tonsillitis or dental abscesses. Risk factors include diabetes, immunosuppression, and poor oral hygiene. The condition can lead to severe complications like mediastinitis, sepsis, or airway obstruction. We present the case of a 42-year-old man with a 10-day history of progressive neck and oral cavity swelling, unresponsive to cefuroxime. Imaging showed extensive abscesses threatening airway patency, prompting tracheotomy, surgical drainage, and tonsil removal. Intraoperatively, the patient suffered cardiac arrest but was successfully resuscitated. Cultures grew Klebsiella pneumoniae and streptococci; targeted antibiotic therapy led to clinical improvement and discharge. This case highlights the importance of rapid diagnosis, airway protection, surgical intervention, and tailored antibiotic therapy in managing deep neck abscesses, especially in patients with chronic conditions. Early recognition and treatment are essential to reduce complications and improve outcomes.
Keywords
phlegmon of the neck, tracheotomy, abscess drainage, antibiotic therapy, combined treatment, Klebsiella pneumoniae
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