[Hyperbaric oxygen therapy in case of the neck diffuse phlegmon with very hard clinical course]

A case of 56 year old woman, diabetic (non-diagnosed before), suffering from diffuse phlegmon of the neck and acute submucosal laryngitis as a peritonsillar abscess complication is presented. Tracheotomy, abscess tonsillectomy with evacuation of peritonsillar abscess and extensive skin incisions of the neck with separation of tissue layers followed by drainage were performed at the beginning of hospitalization. This was regarded as responsible for stopping the violent development of the disease and saving the life of patient. Pathological bacteria were Streptococci (anaerobic and aerobic). Apart from the application of antibiotics (piperacyl, amikin, metronidazole) the patient was treated by hyperbaric oxygen (pressure 2,5 ata, one hour per day, on 6-9 day of treatment). Furthermore she was treated with oxygen applied through the tracheotomy tube during 5 days. In the authors' opinion the early performance of surgical procedure is necessary in the phlegmon of the neck as in the presented case. It is to be remembered, that these patients may suffer from other diseases like diabetes, non-diagnosed earlier. It has been noticed that significant improvement may be obtained by using the hyperbaric oxygen in the treatment of such cases.