Sandbox ID Head and Neck: Difference between revisions

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*viral <ref name="pmid19608051">{{cite journal| author=Patel A, Karlis V| title=Diagnosis and management of pediatric salivary gland infections. | journal=Oral Maxillofac Surg Clin North Am | year= 2009 | volume= 21 | issue= 3 | pages= 345-52 | pmid=19608051 | doi=10.1016/j.coms.2009.05.002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19608051  }} </ref>
*viral <ref name="pmid19608051">{{cite journal| author=Patel A, Karlis V| title=Diagnosis and management of pediatric salivary gland infections. | journal=Oral Maxillofac Surg Clin North Am | year= 2009 | volume= 21 | issue= 3 | pages= 345-52 | pmid=19608051 | doi=10.1016/j.coms.2009.05.002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19608051  }} </ref>
:*Preferred regimen: Currently, the accepted treatment for mumps includes supportive care consisting of hydration, oral hygiene and bed rest
:*Preferred regimen: Currently, the accepted treatment for mumps includes supportive care consisting of hydration, oral hygiene and bed rest
===Rhinosinusitis===
===Pharyngitis===
===Tonsillitis===


==References==
==References==
{{reflist}}
{{reflist}}

Revision as of 18:59, 14 July 2015

Anthrax, oropharyngeal

  • Oropharyngeal anthrax[1]

Buccal cellulitis

  • Buccal cellulitis[2]
  • Empiric antimicrobial therapy

Cervico-facial actinomycosis

  • Cervico-facial actinomycosis[3]

Deep neck infection

  • Deep neck infection
  • 1. Empiric antimicrobial therapy[4][5]
  • 1.1 Community-acquired deep neck infection
  • 1.2 Nosocomial deep neck infection or immunocompromised host
  • 1.3 Deep neck infection with high-risk of MRSA
  • 1.4 Necrotizing fasciitis
  • 2. Specific anatomic considerations[6]
  • 2.1 Submandibular space infections including Ludwig angina
  • Causative pathogens
  • Viridans and other streptococci
  • Peptostreptococcus
  • Bacteroides
  • Other oral anaerobes
  • 2.2 Lateral pharyngeal or retropharyngeal space infections (odontogenic)
  • Causative pathogens
  • Viridans and other streptococci
  • Staphylococcus
  • Peptostreptococcus
  • Bacteroides
  • Other oral anaerobes
  • 2.3 Lateral pharyngeal or retropharyngeal space infections (rhinogenic)
  • Causative pathogens
  • Streptococcus pyogenes
  • Fusobacterium
  • Peptostreptococcus
  • Other oral anaerobes
  • 2.4 Lateral pharyngeal or retropharyngeal space infections (otogenic)
  • Causative pathogens
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Viridans and other streptococci
  • Peptostreptococcus
  • Bacteroides
  • Other oral anaerobes
  • 2.5 Peritonsillar abscess (quinsy)
  • Causative pathogens
  • Viridans and other streptococci
  • Peptostreptococcus
  • Bacteroides
  • Other oral anaerobes
  • 2.6 Suppurative parotitis
  • Causative pathogens
  • Staphylococcus
  • Viridans and other streptococci
  • Bacteroides
  • Peptostreptococcus
  • Other oral anaerobes
  • 2.7 Extension of osteomyelitis from prevertebral space infection
  • Causative pathogens
  • Staphylococcus
  • Facultative gram-negative bacilli
  • 2.8 Pott's puffy tumor (frontal osteitis)
  • Causative pathogens
  • Streptococcus pyogenes
  • Fusobacterium
  • Peptostreptococcus
  • Other oral anaerobes
  • 2.9 Malignant otitis media
  • Causative pathogens
  • Pseudomonas aeruginosa
  • 2.10 Petrous osteitis
  • Causative pathogens
  • Pseudomonas aeruginosa
  • 2.11 Septic jugular thrombophlebitis (Lemierre syndrome)
  • Causative pathogens
  • Fusobacterium
  • Viridans and other streptococci
  • Staphylococcus
  • Peptostreptococcus
  • Bacteroides
  • Other oral anaerobes

Facial cellulitis

  • Facial cellulitis, odontogenic [7]
  • Causative pathogens
  • Aerobic and facultative organisms
  • Streptococcus, group A beta-hemolytic
  • Neisseria
  • Eikenella
  • Anaerobic organisms
  • Prevotella
  • Peptostreptococcus
  • Empiric antimicrobial therapy

Mastoiditis

  • 1. Acute Mastoiditis [8]
  • 1.1 Causative pathogens:
  • Streptococcus pneumoniae
  • Streptococcus pyogenes
  • Staphylococcus aureus
  • Hemophilus influenzae
  • Pseudomonas aeruginosa
  • 1.2 Acute mastoiditis, outpatient
  • 1.2.1 Empiric antimicrobial therapy
  • Preferred regimen (no abx in past month): Amoxicillin 50 mg/kg/day PO q6h
  • Preferred regimen (abx in past month): Amoxicillin-Clavulanate 90 mg/kg/day PO q12h OR Cefdinir 14 mg/kg PO q24h OR Cefpodoxime 10 mg/kg/day PO q12h OR Cefprozil 30 mg/kg/day PO q12h OR Cefuroxime 15 mg/kg/day PO q12h
  • Note: Duration of treatment in children <2 years-old is 10 days. In children ≥2 years, recommended duration is 5–7 days. Maximum dose for Cefpodoxime is 400 mg/day. Maximum dose for Cefprozil is 1 g/day. Maximum dose for Cefuroxime is 1 g/day.
  • 1.2.2 Pathogen-directed antimicrobial therapy
  • 1.2.2.1 Staphylococcus aureus (MSSA)
  • Preferred regimen: Oxacillin 37 mg/kg IV q6h
  • Note: Maximum dose is 8-12 g/day
  • 1.2.2.2 Staphylococcus aureus (MRSA)
  • Preferred regimen: Vancomycin 40 mg/kg/day IV q6-8h
  • Note: Maintain Vancomycin serum trough concentrations of 15-20 mcg/mL
  • 1.3 Acute mastoiditis, inpatient
  • 1.3.1 Empiric antimicrobial therapy
  • 1.3.2 Pathogen-directed antimicrobial therapy
  • 1.3.2.1 Staphylococcus aureus (MSSA)
  • Preferred regimen: Oxacillin 37 mg/kg IV q6h
  • Note: Maximum dose is 8-12 g/day
  • 1.3.2.2 Staphylococcus aureus (MRSA)
  • Preferred regimen: Vancomycin 40 mg/kg/day IV q6-8h
  • Note: Maintain Vancomycin serum trough concentrations of 15-20 mcg/mL
  • 2. Chronic Mastoiditis[9]
  • 2.1 Causative pathogens:
  • Polymicrobial
  • Enterobacteriaceae
  • Staphylococcus aureus
  • Pseudomonas aeruginosa
  • 2.2 Empiric antimicrobial therapy

Odontogenic infection

  • Odontogenic infection[10]

Orbital cellulitis

  • Orbital cellulitis [11]


((((((Vancomycin (in children: 40 to 60 mg/kg IV per day in three or four divided doses, maximum daily dose 4 g; in adults: 30 to 60 mg/kg IV per day in two or three divided doses; the appropriate dose in adults requires measurement of a trough concentration of vancomycin) plus one of the following:

•Ceftriaxone (in children: 50 mg/kg per dose IV once or twice per day [the higher dose should be used if intracranial extension is suspected], maximum daily dose 4 g/day; in adults: 2 g IV every 24 hours [2 g IV every 12 hours if intracranial extension is suspected]) or

•Cefotaxime (in children: 150 to 200 mg/kg IV per day in three doses, maximum daily dose 12 g; in adults: 2 g IV every four hours) or

•Ampicillin-sulbactam (in children: 300 mg/kg IV per day in four divided doses in children, maximum daily dose 12 g ampicillin-sulbactam [8 g ampicillin component]; in adults: 3 g IV every six hours) or

•Piperacillin-tazobactam (in children: 240 mg/kg per day in three divided doses, maximum daily dose 16 g of piperacillin component; in adults: 4.5 g IV every six hours))))))))))))))

Oropharyngeal candidiasis

  • Oropharyngeal candidiasis[12]

Otitis externa

  • 1. Otitis externa, acute [13]
  • 1.1 Causative pathogens
  • Pseudomonas aeruginosa
  • Candida spp.
  • Enterobacteriaceae
  • Proteus spp.
  • Staphylococcus aureus
  • 1.2 Empiric antimicrobial therapy
  • 1.3 Pathogen-directed therapy
  • 1.3.1 Fungal otitis externa[13]
  • 1.3.2 Malignant otitis media, Pseudomonas aeruginosa[13]
  • 2. Otitis externa, chronic[13]
  • 2.1 Empiric antimicrobial therapy

Otitis media

Otitis media, Acute

Otitis media, Post-intubation

Otitis media, Prophylaxis

Otitis media, Treatment failure

Note: Consider Tympanocentesis if clinically indicated.

Parotitis

  • Preferred regimen
  • MSSA : Nafcillin or oxacillin 2 gm IV q4h
  • MRSA : vancomycin
  • Juvenile recurrent parotitis [18]
  • Preferred regimen: B-lactam antibiotics (Penicillin VK or Amoxicillin–clavulanate for staphylococcal coverage)
  • Preferred regimen: Short-term, low-dose corticosteroid therapy can reduce inflammation and promote faster restoration of glandular function.
  • Preferred regimen: Currently, the accepted treatment for mumps includes supportive care consisting of hydration, oral hygiene and bed rest

Rhinosinusitis

Pharyngitis

Tonsillitis

References

  1. Hendricks KA, Wright ME, Shadomy SV, Bradley JS, Morrow MG, Pavia AT; et al. (2014). "Centers for disease control and prevention expert panel meetings on prevention and treatment of anthrax in adults". Emerg Infect Dis. 20 (2). doi:10.3201/eid2002.130687. PMC 3901462. PMID 24447897.
  2. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  3. Wong VK, Turmezei TD, Weston VC (2011). "Actinomycosis". BMJ. 343: d6099. doi:10.1136/bmj.d6099. PMID 21990282.
  4. Flint, Paul (2010). Cummings otolaryngology head & neck surgery. Philadelphia, PA: Mosby/Elsevier. ISBN 978-0323052832.
  5. Vieira, Francisco; Allen, Shawn M.; Stocks, Rose Mary S.; Thompson, Jerome W. (2008-06). "Deep neck infection". Otolaryngologic Clinics of North America. 41 (3): 459–483, vii. doi:10.1016/j.otc.2008.01.002. ISSN 0030-6665. PMID 18435993. Check date values in: |date= (help)
  6. Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
  7. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  8. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  9. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  10. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  11. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  12. Pappas PG, Kauffman CA, Andes D, Benjamin DK, Calandra TF, Edwards JE; et al. (2009). "Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America". Clin Infect Dis. 48 (5): 503–35. doi:10.1086/596757. PMID 19191635.
  13. 13.0 13.1 13.2 13.3 Rosenfeld RM, Schwartz SR, Cannon CR, Roland PS, Simon GR, Kumar KA; et al. (2014). "Clinical practice guideline: acute otitis externa executive summary". Otolaryngol Head Neck Surg. 150 (2): 161–8. doi:10.1177/0194599813517659. PMID 24492208.
  14. 14.0 14.1 Lieberthal AS, Carroll AE, Chonmaitree T, Ganiats TG, Hoberman A, Jackson MA; et al. (2013). "The diagnosis and management of acute otitis media". Pediatrics. 131 (3): e964–99. doi:10.1542/peds.2012-3488. PMID 23439909.
  15. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  16. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  17. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  18. 18.0 18.1 Patel A, Karlis V (2009). "Diagnosis and management of pediatric salivary gland infections". Oral Maxillofac Surg Clin North Am. 21 (3): 345–52. doi:10.1016/j.coms.2009.05.002. PMID 19608051.