당뇨환자에서 심경부감염에 대한 임상적 고찰

Abstract

Background and Objectives：Patients with diabetes mellitus (DM) have suppressed immunity, and the clinical course are always more severe and may cause life-threatening complications. This article investigates the differences in clinical manifestation of deep neck infections between diabetic patients and nondiabetic patients and to take this into account for their treatment. Subjects and Method：The present study reviews the experience of 158 patients with deep neck infections from 1995 to 2004. Cases of peritonsillar abscess, superficial infection, and infections related to external neck wound and head and neck tumors were excluded. Among 158 patients, 27 patients were presented with DM. To find out the characteristics of diabetic patients, the author compared these patients with nondiabetic patients using student t-test and chi-square test. Results：Compared with the nondiabetic patients, the unique features of deep neck infections in diabetic patients were as follows：1) tendency to have Klebsiella pneumoniae as a pathogen, 2) prolonged hospitalization, and 3) higher complication rate (p<0.05). There were no significant differences in sex, duration of symptom, fever higher than 38.0℃, white blood cell count, etiology, and involved spaces between two groups (p>0.05). Conclusion：Patients with DM were found to have Klebsiella pneumoniae pathogen, higher complication rate, and longer hospitalization. Doctors should keep close observation, appropriately control the diabetes, detect life-threatening complications early, perform aggressive surgical treatment if fluctuations or complications occurs, and take into account the preponderance of Klebsiella pneumoniae when administering empirical antibiotics. (Korean J Otolaryngol 2006;49:323-7)