For patients who have difficulty in taking food orally or tube feeding, parenteral nutrition may be achieved using a Peripherally Inserted Central Catheter (PICC). The head and neck region also appear to be particularly useful insertion sites. However, while it is convenient to improve the nutrition of patients, various complications can occur often; e.g., nerve damage, phlebitis and brachial deep vein thrombosis. Among the many complications, fungemia and sepsis, catheter-related bloodstream infections (CR-BSI) are likely to be serious and have high risk of catastrophic changes. Sometimes, CR-BSI occurs with a detention PICC or central venous catheter (CVC), but it is possible to prevent and especially it is important to perform maximal barrier precautions. Mycotic endophthalmitis from CR-BSI also increases the risk of vision loss and blindness. For that reason, if fungal infection is suspected, prompt administration of antifungal drugs is recommended even without a definitive diagnosis, such as a blood culture test.

In this case, we encountered a fungal endophthalmitis in a 73-year-old male with HPV-positive tonsil cancer, who underwent PICC insertion and detained. He suffered from fungemia and sepsis due to CR-BSI. We administered antifungal drugs for 59 days after the diagnosis of fungemia and fungal endophthalmitis, which led to recovery of the patient.

Purpose: To evaluate the usefulness of Computed tomography (CT)-guided core needle biopsy (CNB) in head and neck tumors.

Methods: CT-guided CNB was performed on 7 patients with deep head and neck region tumors that could not be easily accessed by conventional methods from November 1, 2014 to January 31, 2020. We reviewed the medical records retrospectively to confirm the definitive diagnosis, treatment, clinical follow-up, complications and examine the utility of CT-guided CNB.

Results: The patients included 4 lesions in the parapharyngeal space, 1 lesion in the infratemporal fossa, and 2 lesions in the deep lobe of the parotid gland. Biopsy specimens were obtained sufficiently in 6 of 7 cases (85.7%), histologic confirmation was found and used to determine the treatment course in all cases. No major complications or dissemination were identified.

Conclusion: CT-guided CNB of lesions located deep in the head and neck is a safe and convenient method. Diagnostic needle biopsies allow the avoidance of unnecessary open biopsies and surgery. CT-guided CNB can be a useful diagnostic method in the general practice of otorhinolaryngological and cervical surgeons.

Pott’s Puffy Tumor (PPT) is a rare condition where acute frontal sinusitis spreads to the bone of the forehead, causing the formation of an abscess. In this report, we discuss a case involving a 66-year-old male patient who experienced recurring forehead swelling and pain for three months, with clinical findings suggesting frontal sinusitis. Upon examination, the patient’s forehead showed redness, swelling, and tenderness. Purulent nasal discharge and mucosal swelling were observed in the left middle nasal meatus. A contrast-enhanced CT scan revealed a soft tissue shadow with ring enhancement in the left frontal sinus, and soft tissue shadows in the left ethmoid sinus and left maxillary sinus. On the third day after admission, Endoscopic Sinus Surgery (ESS) and an external nasal incision were performed. Pus accumulation was found in the frontal sinus, and a device called HydroCleanse^TM was inserted to clean and aspirate the area. During a left eyebrow incision, partial frontal bone destruction and unobstructed frontal sinus were observed. The necrotic bone and granulation tissues were removed as much as possible, and a Penrose drain was inserted at the eyebrow incision site for postoperative care. Following the surgery, the patient’s frontal sinus was cleaned daily with saline through the Penrose drain. The drain was removed on the 14th day after admission, with no signs suggesting recurrence. The patient showed a favorable recovery and was discharged on the 42nd day after admission, demonstrating a successful treatment outcome for this challenging case of Pott’s Puffy Tumor.