Background: Peritonsillar abscess (PTA) is an infectious emergency in the head and neck, and patients with end-stage renal disease (ESRD) have an immunocompromised status. However, no relevant research has focused on the ESRD–PTA relationship. This study explored PTA in ESRD patients and their prognosis. Methods: We identified 157,026 patients diagnosed as having ESRD over January 1997 to December 2013 from Taiwan’s National Health Insurance Research Database (NHIRD). Each patient with ESRD (hereafter, patients) was matched with one control without chronic kidney disease (CKD; hereafter, controls) by sex, age, urbanization level, and income. Next, PTA incidence until death or the end of 2013 was compared between the two groups, and the relative risk of PTA was analyzed using a multiple logistic regression model. Results: The patients had a significantly higher PTA incidence than did the controls (incidence rate ratio: 2.02, 95% confidence interval [CI]: 1.40–2.91, p < 0.001). The Kaplan–Meier analysis revealed that the patients had a higher cumulative incidence of PTA than did the controls (p < 0.001). In Cox regression analysis, the patients had nearly twofold higher PTA risk (adjusted hazard ratio [HR]: 1.98, 95% CI: 1.37–2.86, p < 0.001). The between-group differences in the PTA-related hospital stay length (8.1 ± 10.3 days in patients and 5.7 ± 4.6 days in controls, p = 0.09), consequent deep-neck infection complication (4.2% in patients and 6.3% in controls, p = 0.682), and mortality (0.0% in both groups) were nonsignificant. Conclusions: Although ESRD does not predict a poor prognosis of PTA, it is an independent PTA risk factor.

Acute epiglottitis (AE) is a potential emergency of the respiratory tract caused mainly by bacterial infection. However, nonbacterial infection causes, such as corrosive injuries, may result in death due to gastrointestinal perforation if a timely diagnosis is not available. We report the case of an elderly patient with an acute melancholic episode who encountered corrosive epiglottitis (CE) caused by accidental ingestion of hydrochloric acid and compare the features of CE and AE, including the immediate onset of symptoms, normal findings on blood tests, and endoscopy revealing pale swollen epiglottitis. This case can prove to be an important reference for clinicians for differential diagnosis, especially when treating epiglottitis in patients with psychiatric disorders and unclear expression.

Adult deep neck infection (DNI) is a potentially life-threatening condition associated with significant morbidity and mortality. Contemporary large-scale data characterizing long-term microbial evolution and clinical outcome trends in adult DNI remain limited. This study aimed to investigate temporal changes in bacterial pathogens, treatment strategies, and clinical outcomes of adult DNI across an 18-year period. This is a retrospective multicenter cohort study using the Chang Gung Research Database (CGRD) and a de-identified nationwide database from Taiwan’s largest medical system. Hospitalized adult patients (aged ≥18 years) with DNI from 2006 to 2023 were identified and stratified into two consecutive 9-year epochs (Epoch 1: 2006–2014, n = 5512; Epoch 2: 2015–2023, n = 6551). Demographics, comorbidities, treatment modalities, disease severity, and microbiological profiles were analyzed. Bacterial isolates were evaluated at genus and species levels, with methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA) assessed separately. Among 12,063 adult DNI patients (Epoch 1: n = 5512; Epoch 2: n = 6551), antibiotic-only treatment increased (77.3% to 83.2%) and surgical intervention decreased (22.7% to 16.9%). Descending necrotizing mediastinitis decreased markedly (2.7% to 0.7%) and in-hospital mortality declined (7.7% to 6.4%). Poly-microbial infections increased substantially (45.3% to 53.7%). Among facultative anaerobic and aerobic isolates, the Streptococcus anginosus group (SAG) emerged as a clinically important pathogen. Among anaerobes, Prevotella displaced Peptostreptococcus as the dominant genus, with Peptostreptococcus micros (Parvimonas micra) and Prevotella buccae emerging as prominent species. Over 18 years, adult DNI in Taiwan demonstrated significant improvements in clinical outcomes, with marked reductions in mediastinitis and in-hospital mortality. Concurrently, poly-microbial infections increased, and the SAG, Peptostreptococcus micros (Parvimonas micra), Prevotella, and anaerobic organisms emerged as clinically important pathogens, underscoring the need for empiric antibiotic regimens providing broad aerobic and anaerobic coverage. Although microbiological profiles vary geographically, these findings provide a contemporary evidence base to guide empiric antibiotic selection, inform surgical decision-making, and identify high-risk adult patients with DNI.