PMC8202303_01
(a) Pre-operative cervical ultrasound image. Extensive hypoechoic areas with indistinct borders noted in the left mandible and just below the sternocleidomastoid muscle in the left neck. (b) Pre-operative contrast-enhanced computed tomography. A low-density area is seen from the left mandible to the left deep neck. The same area has a contrast effect on the margins and an internal septum.
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Ultrasonography showed a hypoechoic area from the left submandibular space to the carotid artery space, and a diagnosis of neck abscess associated with left peritonsillitis was made (Figure 1(a)). A contrast-enhanced computed tomography (CECT) revealed a huge abscess with a septum on the left side of the neck; however, it did not show continuity from the root of the tooth to the abscess (Figure 1(b)).
(a) Susceptibility of various antimicrobial agents to Parvimonas micra. No resistance to any antimicrobial agent observed. (b) Post-hospitalization progress. On the day of admission, the abscess was punctured and incision and drainage were performed under general anesthesia. Antimicrobial agents were administered as shown in this figure. The patient's symptoms improved quickly with a decrease in inflammation.. MIC: minimal inhibitory concentration; PCG: penicillin G; ABPC: ampicillin; ABPC/SBT: ampicillin/sulbactam; AMPC/CVA: amoxicillin/clavulanate; TAS/PIPC: tazobactam/piperacillin; CMZ: cefmetazole; CZX: ceftizoxime; IPM/CS: imipenem/cilastatin; MEPM: meropenem; CLDM: clindamycin; MINO: minocycline; CP: chloramphenicol; WBC: white blood cell; CRP: C-reactive protein.
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All antimicrobial agents were susceptible to Parvimonas micra (Figure 2(a)). The drain was removed on the 9th postoperative day, and the patient was discharged on the 13th postoperative day (Figure 2(b)).