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TORTİKOLLİS İLE BAŞVURAN İKİ PARAFARENGEAL ABSE VAKASI. CERRAHİ TEDAVİ Mİ? MEDİKAL TEDAVİ Mİ?

CASE REPORT OF TWO PARAPHARYNGEAL ABSCESS PATIENTS PRESENTED WİTH TORTİCOLLIS MEDICAL OR SURGICAL TREATMENT?

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2010

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Here we present two parapharyngeal abscess patients presented with torticollis. We will review the treatment modalities of parapharyngeal abscesses in children. Case 1: A 25 months old male presented with torticollis. Laboratory tests revealed WBC count: 20400/ mm3 and CRP:76,8 mg/L. Neck CT revealed parapharyngeal abscess. Intravenous ampicillin-sulbactam and metronidazole combination therapy was started. Under the treatment there was an increase in the size of the abscess and elevation in inflammatory markers. The abscess was drained and sent for culture. MRSA was covered in culture. Intravenous vancomycin and rifampycin was started. At the end of one week treatment, resolution of the abscess was shown by control CT. Case 2: A 8 years old male presented with lump in neck and torticollis. An anterior cervical lymph node was palpated. Inflammatory markers were elevated and neck CT revealed a parapharyngeal abscess. Under the combination antibiotherapy with ampicillin-sulbactam and metronidazole the abscess resolved uneventfully. We conclude that the treatment of parapharyngeal abscess should be individualized according to the patients‟ clinical features and directed according to the follow-up clinical findings.
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Abstract (Original Language): 
Bu yazıda tortikollis ile baĢvuran iki parafarengeal abse olgusu sunuyoruz. Çocuklarda parafarengeal abselere yönelik tedavi seçeneklerini tartıĢacağız. VAKA 1: YirmibeĢ aylık erkek çocuk, boynunu hareket ettirmek istememe Ģikayetiyle getirildi. Laboratuar incelemesinde WBC:20400 / mm3 ve CRP:76,8 mg/L bulundu. Boyun BT incelemelerinde parafarengeal abse ile uyumlu görünüm saptandı. Ġntravenöz ampisilin-sulbaktam ve metronidazol tedavileri baĢlandı. Tedavi altındayken abse boyutunda büyüme ve enflamasyon göstergelerinde yükselme saptandı. Abse drene edildi ve kültüre gönderildi. Kültürde MRSA üremesi oldu. Ġntravenöz vankomisin ve rifampisin tedavisi baĢlandı. Tedavinin birinci haftası bittiğinde kontrol BT incelemesinde absenin kaybolduğu gözlendi. VAKA 2: Sekiz yaĢında erkek hasta, boyunda ĢiĢlik ve eğrilik Ģikayetiyle getirildi. Anterior servikal lenf nodu palpe edilmekteydi. Enflamasyon göstergelerinde yükselme saptandı. Boyun BT incelemesinde parafarengeal abse ile uyumlu görünüm saptandı. Hastaya intravenöz ampisilin-sulbaktam ve metronidazol kombinasyonu baĢlandı. Medikal tedavi ile hasta komplikasyonsuz iyileĢti. Sonuç olarak, parafarengeal abselerde tedavi Ģekli hastaların klinik bulgularına göre seçilmeli ve klinik izlemdeki bulgulara göre yönlendirilmelidir.
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  • Turkish

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