扁桃周囲炎後に発生した側頸部ガス蜂窩織炎1症例

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A 50 years old newsman was complaining of sore throat and odynophagia since June 8, 1974. He was diagnosed as acute peritonsillitis on the left side. Slight swelling in the same side of the neck was also found. He was hospitalized on June 11. Urinalysis revealed glycosuria. The glucose tolerance test showed 242mg/dl blood sugar at 1 hour. On June 17, a crecipitation was proved in the region on the left side of the neck. About 10 ml white pus which looked like melted ice cream was removed by an incision and aspiration. Bacillus in the pus was identified as Clostridium perfringens by use of C W medium and the test paper, which contained the serum of the type A antitoxin. The fore chest with spreading suppurations was incised also. From both incised wounds the pus was continuously aspirated by low negative pressure. In the most serious condition, ca. 100ml pus, contained necrotic tissue was drained daily, resulting a large subcutaneous cavity formation in the neck and the fore chest. The lesion was treated locally by cleaning with Oxydol, pouring Lincomycin in the cavity and application of the solar lampe. Intravenous injection of the immune serum and the administration of aminobenzyl-penicillin and neomyson along with diabetic diet were effective in the treatment of this anaerobic bacillus infection in a diabetic.