Intramural oesophageal abscess: an unusual complication of tonsillitis

Abstract

Tonsillitis is an extremely common condition, usually it is self-limiting, of viral origin, and managed conservatively in general practice. Rarely patients require inpatient management, usually when bacterial infection is present or when the cause is virulent organisms such as Epstein Barr virus. Complications can be divided into non-suppurative; sepsis, scarlet fever, rheumatic fever, glomerulonephritis and Lemierres disease, and suppurative; quinsy, parapharyngeal abscess and retropharyngeal abscess, respectively. Anecdotally, there is concern that modern medical practice that counsels vigilance against overuse of antibiotics, could lead to increased complications of tonsillitis. We report a case of an otherwise healthy man who presented with dysphagia, odynophagia and neck pain following a sore throat. Despite antibiotic treatment he developed an intramural oesophageal abscess, to our knowledge, an unreported complication of tonsillitis.

Intramural Esophageal Abscess Complicated with Pleural Fistula: A Case Report

“…Benatta et al have described the case of an intramural esophageal dissection without abscess, secondary to pharyngitis [1]. Another case report by Amiraraghi et al describes the occurrence of intramural esophageal abscess as an unusual complication of tonsillitis [4]. Lichter et al have described two patients with intramural esophageal abscess formation secondary to iatrogenic trauma [3].…”

“…The mucosal laceration may allow access to the infected material to travel from the lumen of the esophagus to enter the loose submucosal layer, producing a longitudinal dissection with separation of the mucosa from the surrounding esophageal muscle [3]. Intramural esophageal dissections are most often iatrogenic manifestations, which follow instrumentation, treatment of varices, and anticoagulation [4]. Common symptoms include retrosternal chest pain, dysphagia, odynophagia, and hematemesis [5].…”

Treatment of a spontaneous intramural esophageal abscess by endoscopic mucosal incision: an easy and effective therapy

“…5 ); the key to the diagnosis is an awareness of its frequent atypical presentations. In clinical settings, mucosal injury due to either iatrogenic etiology or foreign body ingestion can often help to identify an intramural esophageal abscess 2 ; however, in a healthy and strong young man with no underlying etiology, the diagnosis may be challenging. Three-dimensional reconstruction provided valuable help with the diagnosis in this case and the endoscopic finding of pus from the fistula was highly suggestive of an esophageal abscess.…”

Detection of Tonsillopharyngitis with Grad-Cam and Optimization-Based Model Using Oropharyngeal Images

“…It is a significant health problem because it causes loss in the workforce and can easily be transmitted in family and communal living spaces. Detection of this problem at an early stage is of great importance for treating the patient [5]. In recent years, the use of artificial intelligence methods in the medical field has been the focus of the attention of researchers [6][7][8].…”