Article in Japanese

Deep neck abscess caused by anaerobic bacteria after toothbrush trauma in an infant

Tetsuro TAMAI¹⁾, Yoshifusa ABE²⁾, Takaaki NAGAHAMA¹⁾, Yoshihiro YAMADA⁴⁾, Hideka SAITO³⁾, Takashi SOGA³⁾, Yoh UMEDA³⁾

A 2-year-old girl fell with her toothbrush in her mouth and presented to our hospital the following day with a linear wound on the right palatopharyngeal arch without active bleeding and pain with swallowing. She did not require specific treatment at that time; however, she returned 5 days later with fever, swallowing difficulty, and neck swelling. Contrast-enhanced computed tomography of the neck revealed a right-sided deep neck abscess and dislocated airway, necessitating intubation, as well as incision and drainage of the abscess under general anesthesia. Examination of pus from the abscess revealed the intraoral anaerobes Fusobacterium nucleatum and Eikenella corrodens (common members of resident oral microflora), which were considered causal pathogens associated with the abscess. Toothbrushes are unsterile even after rinsing. Our findings highlight that clinicians should be aware that toothbrush injury can cause deep neck abscesses and airway stenosis secondary to resident oral microflora infection.

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1) Department of Pediatrics Showa University School of Medicine
2) Children's Medical Center, Showa University Koto Toyosu Hospital
3) Children's Medical Center, Showa University Northern Yokohama Hospital
4) Department of Otorhinolaryngology, Showa University Northern Yokohama Hospital

Key words	toothbrush trauma, deep neck abscess, anaerobic bacteria
Received	October 1, 2019
Accepted	June 30, 2020

32 (4)：363─368,2020