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Clinical Infections and Nonsurgical Treatment of Parapharyngeal Space Infections Complicating Throat Infection

Simon de Marie, Richenel T. O. Tjon A. Tham, Andel G. L. van der Mey, Geert Meerdink, Ralph van Furth and Jos W. M. van der Meer
Reviews of Infectious Diseases
Vol. 11, No. 6 (Nov. - Dec., 1989), pp. 975-982
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/4455382
Page Count: 8
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Clinical Infections and Nonsurgical Treatment of Parapharyngeal Space Infections Complicating Throat Infection
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Abstract

The clinical features and management of eight patients with parapharyngeal space infection who presented with swelling of the neck subsequent to sore throat are described. In four patients the interval between the initial throat symptoms and swelling was 2 days or less, and the disease was rapidly progressive with stridor or a descending mediastinitis. In the other four cases, this interval was longer (4 to 14 days) and the infection was fairly localized. Computed tomography was useful for making the diagnosis, establishing that the infection had spread into other deep neck spaces and the mediastinum, distinguishing abscesses from diffuse cellulitis, guiding drainage aspiration, and assessing the response to therapy. None of the patients underwent extensive surgical drainage of the deep neck spaces. A nonsurgical approach with antibiotics, including high doses of benzylpenicillin, and computed tomography-guided selective needle aspirations proved successful. Even patients with distinct abscesses were completely cured.

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