Difficult-to-treat infections

Intensive Care Med. 1990:16 Suppl 3:S239-42. doi: 10.1007/BF01709708.

Abstract

The most common problems in the management of serious bacterial infections were reviewed. As illustrations, the diagnostic and therapeutic strategies in two types of deep-seated infections--both associated with a poor penetration of antibiotics--were discussed: (1) In suppurative central venous thrombophlebitis, conservative therapy frequently fails; if so, one should promptly switch to a surgical approach; (2) in most patients with a parapharyngeal space infection, a non-surgical approach can be recommended including early diagnosis by computed tomography (CT), CT-guided needle aspiration, prompt administration of benzylpenicillin in high and frequent dosages or continuously, and follow-up by CT. This regimen may prevent radical surgery even in the presence of deep neck or mediastinal abscesses.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / diagnosis
  • Bacterial Infections / pathology
  • Bacterial Infections / therapy*
  • Clinical Protocols / standards*
  • Drainage
  • Humans
  • Intensive Care Units
  • Necrosis
  • Pharyngeal Diseases / diagnosis
  • Pharyngeal Diseases / pathology
  • Pharyngeal Diseases / therapy*
  • Suppuration
  • Vascular Diseases / diagnosis
  • Vascular Diseases / pathology
  • Vascular Diseases / therapy*
  • Vena Cava, Superior*

Substances

  • Anti-Bacterial Agents