A 55-year-old man was had suffered from left sore throat for a week was admitted to the hospital because of neck pain and dyspnea. A cervical X-ray and ultrasonography (US) showed a gas shadow at the anterior surface of the neck. CT study of the neck revealed that the abscess developed covering the left retropharyngeal, parapharynegeal, and anterior visceral space following left tonsil. With a diagnosis of gas producing abscess, surgical drainage was performed under general anesthesia. Neck pain and dyspnea soon disappeared and the patient recovered. As we could not confirm the existence of clostridium in a bacteriological study, this case was considered to be of gas producing abscess following acute tonsillitis due to non-clostridium.
Gas producing infection in the neck has been reported in 46 cases in Japan since 1980. They are thought to have poor prognosis. It is considered that a prompt surgical treatment and adequate chemotherapy are important when a gas shadow is found in the neck by X-ray, US and CT.