An analysis of clinical risk factors of deep neck infection

Unique Extension of Peritonsillar Abscess to the Masticator Space Encountered in the Early Phase of Antiviral Therapy for Hepatitis C

“…Specifically, the Streptococcus milleri group (SMG, also referred to as the "Streptococcus anginosus group") has been reported to be the most common isolates of the Streptococcus species [1,7]. In bacterial culture analysis, Streptococcus constellatus was isolated in the current case, which is a member of the SMG.…”

“…Deep head and neck infections show preferred pathways of spread, because they develop inside potential spaces formed and lined by layers of the deep neck fascia [1,2]. A peritonsillar abscess represents an infection between the tonsillar capsule and superior constrictor muscle [2].…”

“…Third, our patient also suffered from fairly controlled diabetes mellitus (DM) attributed to the steroid therapy against telaprevir-related dermatitis. Systemic hyperglycemia results in derangement of the immune system including the neutrophil function, celluar immunity, and complement function [1,16]. Diabetes and advanced age have been reported as predisposing factors for more severe complications with spread of deep neck infection [1,2,16].…”

“…Although the pattern of spread varies among patients, a relatively constant trend in the distribution into spaces seems evident because of the relationship of the cervical fascia, which directs and limits the spread of these infections [1,2]. Peritonsillar abscess is the most common type of deep neck infection, and sometimes extends to the lower cervical space via the parapharyngeal space [1].On the other hand, the masticator space is the most prevalent site of spread from odontogenic infection [3][4][5]. We report a unique case of peritonsillar abscess that showed an unusual extension to the masticator space via the parotid space, encountered after telaprevir therapy for hepatitis C in combination with peginterferonalfa-2b and ribavirin.…”

“…The predominant organisms of the peritonsillar abscess are Streptococcus species and anaerobes such as Fusobacterium or Prevotella species [1,6,7]. Specifically, the Streptococcus milleri group (SMG, also referred to as the "Streptococcus anginosus group") has been reported to be the most common isolates of the Streptococcus species [1,7].…”