The Etiological Bacterial Spectrum of Neck Abscesses of Lymph Node Origin - Gram-Positive and Gram-Negative Bacteria

Abstract

According to our medical practice as maxillofacial and oral surgeons, operated patients with purulent infections of the cervical lymph nodes are not many in number. On the other hand, the presence of a purulent infection requires not only the surgical evacuation of the pus but also the application of antimicrobial preparations. This necessitates good knowledge of the spectrum of the bacterial causative agents of the disease, the determination and analysis of which is the purpose of this original article. The bacteria studied in 181 patients with a mean age of 26.25 years, ranging between 29 days and 82 years, who underwent surgery for suppurating cervical lymph nodes, were retrospectively analyzed over a period of eight years. No bacteria were found in 69 of them. In 83 (74.11%) of the remaining 112 studied patients, the isolated microorganisms were of the gram-positive spectrum -Staphylococcus aureus (n=34), gram-positive resident microflora represented by more than one bacterial species (n=21), Staphylococcus hemolyticus (n=10), Staphylococcus epidermidis (n=9) and beta-hemolytic streptococci (n=9). Gram-negative bacteria were 25.89% (n=29) -Klebsiella pneumoniae (n=8), Bartonella henselae (n=7), Klebsiella oxytoca (n=6), Enterobacter cloacae (n=5) and Flavimonas oryzihabitans (n=3). No anaerobic and fungal microorganisms were isolated. Therefore, antimicrobial therapy in these patients should be directed against both gram-positive and gramnegative bacteria, which in our study were represented in a ratio of approximately three to one in favor of gram-positive microorganisms. Otherwise, we create a prerequisite for the formation of phlegmon on the neck, which hides real chances for the lives of patients.

Tuberculosis: Cliché or Outsider?

“…Three hundred of them are in the head and neck area [ 11 ]. To choose the right antibiotic therapy, it is necessary to know the etiological bacterial spectrum of this purulent disease [ 12 ]. Cervical lymphadenopathy (92.6%) was the most common presentation of peripheral tuberculous lymphadenopathy [ 10 ].…”

Unveiling the Uncommon: A Rare Case of Group A Streptococcus Axillary Lymphadenitis With Ambiguous Presentation Leading to Multiple Misdiagnoses

“…Treatment should always include empiric antibiotic coverage of both gram-positive and gram-negative bacterium, and potentially adding coverage of MRSA [ 19 ]. In the case of this patient, the combination of culture-positive GAS and possible MRSA led to treatment with ampicillin/sulbactam and vancomycin until the cultures were matured.…”

Frontal Headache and Swelling: A Case Report of Pott's Puffy Tumor

“…Frontal sinusitis, the precursor to Pott's puffy tumor, is commonly initiated by bacterial or, less frequently, viral infections. The pathogens most frequently associated with Pott's puffy tumor include Staphylococcus aureus and Streptococcus species [4][5][6]. Several host factors play a role in predisposing individuals to Pott's puffy tumor.…”

“…Long-term follow-up revealed no recurrence of symptoms and complete resolution of the epidural collection, supporting the efficacy of the chosen therapeutic approach. Antimicrobial therapy in these patients should be directed against both gram-positive and gramnegative bacterial species [4,5].…”