[Diffuse spontaneous cervical cellulitis caused by anaerobic bacteria]

Nine cases of diffusal cervical cellulitis due to anaerobes were analysed. Some of them had right away extensions (to the inferior mediastinum or to the face). From these cases, the authors argue their treatment protocol. Surgery was performed immediately after diagnosis, and associated with intensive management. The excision of the necrotic tissue and the aperture of all cervical spaces (particularly the floor to the buccal cavity and the prevertebral space) were made. The source of infection was looked for (most often this being the teeth) and treated at the same time. Bacteriologic aero and anaerobic prelevements were done. A thoracic or facial surgery, being necessary because of persistency or appearance of extension, was performed secondary, after the patient was better prepared with a hyperoxygenation and a triple antibiotic therapy. Life prognosis improved with this treatment protocol. The gravity of the conditions presented by our patients depended more on the presence of an underlying disease (diabetes, immunosuppression, age...) or the delay of the diagnosis than on the cellulitis extension.