[颈面放线菌病1例报告]。

F P Lee, T S Huang, A M Wang
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引用次数: 0

摘要

放线菌感染涉及头部和颈部是不常见的诊断,往往是一个诊断谜耳鼻喉科医生。造成这种情况的原因是由于这种疾病本身不常见,目前普遍缺乏对这种疾病的了解,以及放线菌对目前使用的大多数常见抗生素明显敏感。本病例为典型的颈面放线菌病。一位26岁的男性,在拔出下臼齿后,右侧腮腺腹肌区出现了一个月的咬牙和非特征性肿块。手术引流时发现脓液中有许多黄色砂砾状“硫粒”。这些颗粒的革兰氏染色检查显示大量丝状革兰氏阳性杆菌,其中一些显示真分枝。细菌培养只培养出一种厌氧生物,经生化试验鉴定为以色列放线菌。该患者经进一步强化静脉注射青霉素10天和延长口服四环素治疗2个月后病情好转。我们建议,临床医生和微生物学家提高警觉性的存在厌氧生物作为颈面感染的原因可能导致放线菌病的早期和更频繁的诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Cervicofacial actinomycosis: report of a case].

Actinomycotic infection involving the head and neck is not commonly diagnosed and is often a diagnostic enigma to the otolaryngologist. The reasons for this are due to the infrequency of this disease itself, the current general lack of familiarity with this disease and the pronounced sensitivity of actinomyces organisms to most of the common antibiotics in current use. The case reported here is fairly typical of cervicofacial actinomycosis. A 26-year-old man suffering from trismus and a noncharacteristic mass over the right parotidomasseteric region for one month after a lower molar tooth was extracted presented at our hospital. There were many yellowish gritty "sulfur granules" found within the pus when surgical drainage was made. Immediate Gram stain examination of these granules showed numerous filamentous Gram-positive bacilli, some of which showed true branching. Bacterial culture grew only an anaerobic organism which was identified as Actinomyces israelii by biochemical tests. This patient improved after further treatment with intensive intravenous penicillin injections for ten days and prolonged oral tetracycline treatment for two months. We suggest that increased alertness of clinicians and microbiologists to the presence of anaerobic organisms as the cause of cervicofacial infections could result in an earlier and more frequent diagnosis of actinomycosis.

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