Three Patients With Gas Gangrene of the Head and Neck

Ohi, Kiyoyuki; Inamura, Naoki; Suzuki, Mamoru; Suzuki, Naohiro; Ishigaki, Motoaki; Takasaka, Tomonori

doi:10.3950/jibiinkoka.96.1079

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…Gas gangrene of neck spaces have been reported as a result of acute pharyngolaryngeal inflammation (46%), odontogenic causes (27%), trauma (8%), and unknown etiology (19%) [ 3 , 4 ]. Our patient had an odontogenic infection with concomitant diabetes mellitus that led to gas gangrene, severe sepsis, and multiorgan dysfunction syndrome.…”

Section: Discussionmentioning

confidence: 99%

A 52-Year-Old Diabetic Man with Poor Dental Hygiene, Right Dental Abscess, and Parapharyngeal Abscess with Gas Gangrene Due to Klebsiella pneumoniae Infection, Presenting with Septic Shock and Multiorgan Failure, Who Recovered After Surgical Neck Debridement

Sookdee,

Jianbunjongkit

2023

Am J Case Rep

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Patient: Male, 52-year-old Final Diagnosis: Gas gangrene in the deep neck spaces with Klebsiella pneumoniae septicemia Symptoms: Painful swelling of the right-sided neck associated with spiking fever, confusion and dyspnea Clinical Procedure: Neck exploration for drainage Specialty: Otolaryngology Objective: Rare disease Background: Gas gangrene is a rapidly progressive and potentially fatal infection that is common in the extremities. Gas gangrene of the head and neck is a very rare condition, and non-clostridial gas-forming neck abscess caused by Klebsiella pneumoniae is unusual. This report is of a diabetic man with poor dental hygiene, a right dental abscess, and parapharyngeal abscess with gas gangrene due to Klebsiella pneumoniae infection, presenting with septic shock and multiorgan failure, who recovered after surgical neck debridement. Case Report: A 52-year-old man with diabetes mellitus lost consciousness and collapsed on a curbside. He presented with painful swelling of the right-side neck, associated with spiking fever, confusion, dyspnea, and stridor. He had right submandibular and supraclavicular swelling with crepitus, multiple dental caries, and multiorgan dysfunction, and was intubated. A computed tomography scan showed a gas-forming abscess in the right parapharyngeal, retropharyngeal, and paralaryngeal spaces and dense infiltration with pleural effusion in the upper lobes. Neck exploration was performed for drainage. Necrotic tissue and foul-smelling pus were debrided and drained. Gram stain showed gram-negative bacilli. Necrotic tissue, pus, and blood culture showed Klebsiella pneumoniae . He remained on intravenous meropenem for 14 days and was frequently debrided with irrigation until the infection subsided. Finally, normal physiologic functions of the failing organ system were restored. Conclusions: We present a rare case of Klebsiella pneumoniae infection causing gas gangrene in the deep neck spaces, leading to septic shock and multiorgan failure, who recovered after surgical neck debridement. This is a potentially fatal condition that requires emergency drainage because of its high mortality rate.

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Section: Discussionmentioning

confidence: 99%

A 52-Year-Old Diabetic Man with Poor Dental Hygiene, Right Dental Abscess, and Parapharyngeal Abscess with Gas Gangrene Due to Klebsiella pneumoniae Infection, Presenting with Septic Shock and Multiorgan Failure, Who Recovered After Surgical Neck Debridement

Sookdee,

Jianbunjongkit

2023

Am J Case Rep

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“…Computed tomography at the time of the initial examination also showed air bubbles in the infratemporal fossa, suggesting the formation of gas-producing pus. Microorganisms causing gas-producing pus can be broadly divided into anaerobic bacteria in the genus Clostridium (the so-called "gas gangrene bacilli") and non-Clostridium anaerobic bacteria, with the former tending to cause the development of more serious conditions 13,14) .…”

Section: Discussionmentioning

confidence: 99%

A Case of Infratemporal Fossa Abscess with Signs of Chronic Maxillary Osteomyelitis

Kasahara

Ogawa

Matsuzaka

et al. 2015

Bull. Tokyo Dent. Coll.

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The infratemporal fossa is bordered superiorly by the infratemporal surface of the greater wing of the sphenoid bone and part of the temporal bone; medially by the lateral plate of the pterygoid process of the sphenoid bone; and anteriorly by the posterior surface of the maxilla. As it is completely surrounded by bone, it is frequently difficult to determine whether an abscess is present by direct visual observation or palpation alone. We report an extremely rare case of an infratemporal fossa abscess arising from chronic maxillary osteomyelitis developing after extraction of a maxillary molar. Despite drainage during initial oral anti-inflammatory treatment, pus continued to drain from the wound over a long period of time. This drainage ended when the eroded bone of the maxillary tuberosity on the affected side was curetted in a secondary procedure. The harvested bone tissue exhibited histological findings of chronic osteomyelitis. This suggests that the route of infection involved acute transformation of maxillary osteomyelitis by odontogenic infection advancing posteriorly and superiorly.

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Three Patients With Gas Gangrene of the Head and Neck

Cited by 2 publications

References 3 publications

A 52-Year-Old Diabetic Man with Poor Dental Hygiene, Right Dental Abscess, and Parapharyngeal Abscess with Gas Gangrene Due to Klebsiella pneumoniae Infection, Presenting with Septic Shock and Multiorgan Failure, Who Recovered After Surgical Neck Debridement

A 52-Year-Old Diabetic Man with Poor Dental Hygiene, Right Dental Abscess, and Parapharyngeal Abscess with Gas Gangrene Due to Klebsiella pneumoniae Infection, Presenting with Septic Shock and Multiorgan Failure, Who Recovered After Surgical Neck Debridement

A Case of Infratemporal Fossa Abscess with Signs of Chronic Maxillary Osteomyelitis

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