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Purulent parotitis in botulism
ODONTOGENIC
ABSCESSES
und therapeutische Erfahrungen bei cervicofacialer Aktinomykose. and Therapeutic Experiences in Cases of Cenricofacial Actinomycosis.) Ztschr. f. Stomatol. 48: 67, 1951.
Klinische
(Clinical E. Zitka.
Experiences in the treat,ment of Ii’6 cases of cervicofacial a<*tinomycosis over a period of twenty-five years are described. The author concludes that there is no specific t,herapy which cau be used routinely, since the various Wolf-Israel varietier; rea(+ differently to medication. In spite of early diagnosis cases lrere encountered which cxnded fatally no matter what therapy was used. T?p to the year 1944 the best results were obtained by x-ray therapy combined with surgery and iodine medication. Later vaccine therapy was favorcll, and more recently gootl success was obtained with penicillin. In isolated cases cures were obtained with surgical therapy alone. If the infection was superficial the opening of subcutaneous abscesses was sufficient. If the tissues were deeply infiltrated with muscular involvement, wide surgical incision combined with excision of necrotic tissue was combined with drainage. The roe?ztgen therapy consisted, in the beginning, of small doses (150 to 200 r.) given in a series of three to four irradiations over successive days. Later the doses were increased to 200 r. so that the entire doses pro serie amounted to 2,000 r. The individual doses were given every other day. The iodine therapy is used not because of a specific action of iodine on the fungus, but because it causes solution and resorption of the infiltrate. In the beginning it was However, it was found that almost increased to 24 Gm. per day, according to the tolerance. the same effect could be obtained with 2 to 6 Gm. and that the smaller dose could be better tolerated by the patient. The penicillin therapy requires that very high doses be administered. Doses of 500,000 to l,OOO,OOO units were used, and often in combination with sulfonamides, the resistance of some of the Wolf-Israel varieties of the organism being between four and sixteen times stronger than that of the Stapl~ylococcus aureus. The treatment of the lighter cases extended over two to four months. In case of deeper boric, the treatment and postoperative check-ups must be processes, especially those involving continued long after the disease appears cured, to prevent possible recurrence. H. R. RI.
DISEASES Eitrige
Paratitis
f. Laryng.,
bei Botulismus.
OF THE SALIVARY (Purulent
Parotitis
GLANDS
in Botulism.)
K. G. Baum.
Xtschr.
Rhin., Otol. 11: 551, 1950.
A case of botulism is cited to point out that purulent complications involving the salivary glands occur in 15 to 20 per cent. The patient, a woman, became ill after eating a fish. She suffered from gastroenteritis associated with dryness of the mouth, and bulbar and general paralysis. On the twelfth day of her illness her temperature mounted as a rapidly inThe skin over t,hc swelling was red, pus creasing swelling of her left cheek appeared. escaped from Stensen’s duct, trismus set in, and the lymph nodes anterior to the sternomastoid The parotid gland was muscle became enlarged and painful, but there was no fluctuation. incised in three places, in a horizontal direction starting at the tragus, vertically at the level of the lobe of the ear, anterior to the mastoid process, and at the lower pole parallel to the A great deal of pus was evacuated and a partial facial paralysis inferior border of the jaw. After healing with the aid of antibiotic therapy had progressed sufficiently, a resulted. sialogram was made which showed enlargement of two branches of the duct but no other abnormality. The toxin of botulism iu this ~‘;tse l~roducetl paralysis of the vegetative secretory nerves The resulting xerostomia allows the pathogenic organisms to increase of the salivary glands. rapidly and produce an infection of the gland, aseending through the duct, being facilitated because of the decreased flow of the saliva. k.. I’. s.
ABSCESSES
und therapeutische Erfahrungen bei cervicofacialer Aktinomykose. and Therapeutic Experiences in Cases of Cenricofacial Actinomycosis.) Ztschr. f. Stomatol. 48: 67, 1951.
Klinische
(Clinical E. Zitka.
Experiences in the treat,ment of Ii’6 cases of cervicofacial a<*tinomycosis over a period of twenty-five years are described. The author concludes that there is no specific t,herapy which cau be used routinely, since the various Wolf-Israel varietier; rea(+ differently to medication. In spite of early diagnosis cases lrere encountered which cxnded fatally no matter what therapy was used. T?p to the year 1944 the best results were obtained by x-ray therapy combined with surgery and iodine medication. Later vaccine therapy was favorcll, and more recently gootl success was obtained with penicillin. In isolated cases cures were obtained with surgical therapy alone. If the infection was superficial the opening of subcutaneous abscesses was sufficient. If the tissues were deeply infiltrated with muscular involvement, wide surgical incision combined with excision of necrotic tissue was combined with drainage. The roe?ztgen therapy consisted, in the beginning, of small doses (150 to 200 r.) given in a series of three to four irradiations over successive days. Later the doses were increased to 200 r. so that the entire doses pro serie amounted to 2,000 r. The individual doses were given every other day. The iodine therapy is used not because of a specific action of iodine on the fungus, but because it causes solution and resorption of the infiltrate. In the beginning it was However, it was found that almost increased to 24 Gm. per day, according to the tolerance. the same effect could be obtained with 2 to 6 Gm. and that the smaller dose could be better tolerated by the patient. The penicillin therapy requires that very high doses be administered. Doses of 500,000 to l,OOO,OOO units were used, and often in combination with sulfonamides, the resistance of some of the Wolf-Israel varieties of the organism being between four and sixteen times stronger than that of the Stapl~ylococcus aureus. The treatment of the lighter cases extended over two to four months. In case of deeper boric, the treatment and postoperative check-ups must be processes, especially those involving continued long after the disease appears cured, to prevent possible recurrence. H. R. RI.
DISEASES Eitrige
Paratitis
f. Laryng.,
bei Botulismus.
OF THE SALIVARY (Purulent
Parotitis
GLANDS
in Botulism.)
K. G. Baum.
Xtschr.
Rhin., Otol. 11: 551, 1950.
A case of botulism is cited to point out that purulent complications involving the salivary glands occur in 15 to 20 per cent. The patient, a woman, became ill after eating a fish. She suffered from gastroenteritis associated with dryness of the mouth, and bulbar and general paralysis. On the twelfth day of her illness her temperature mounted as a rapidly inThe skin over t,hc swelling was red, pus creasing swelling of her left cheek appeared. escaped from Stensen’s duct, trismus set in, and the lymph nodes anterior to the sternomastoid The parotid gland was muscle became enlarged and painful, but there was no fluctuation. incised in three places, in a horizontal direction starting at the tragus, vertically at the level of the lobe of the ear, anterior to the mastoid process, and at the lower pole parallel to the A great deal of pus was evacuated and a partial facial paralysis inferior border of the jaw. After healing with the aid of antibiotic therapy had progressed sufficiently, a resulted. sialogram was made which showed enlargement of two branches of the duct but no other abnormality. The toxin of botulism iu this ~‘;tse l~roducetl paralysis of the vegetative secretory nerves The resulting xerostomia allows the pathogenic organisms to increase of the salivary glands. rapidly and produce an infection of the gland, aseending through the duct, being facilitated because of the decreased flow of the saliva. k.. I’. s.