Laryngeal abscess formation in an immunosuppressed patient: A case report

Vanhille, Derek L.; Blumin, Joel H.

doi:10.1002/lary.26693

Cited by 5 publications

(2 citation statements)

References 10 publications

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“…Diabetes mellitus, corticosteroid administration, and an immunocompromised status are risk factors for the development of laryngeal abscesses [9]. Our patient had a medical history of diabetes mellitus and a low Alb level (Alb 2.8 g/dL on the 13th postoperative day) on blood test.…”

Section: Discussionmentioning

confidence: 80%

Laryngeal abscess formation secondary to utilization of nasogastric tube in oral cancer patient: A case report

Nishi,

Yamada,

Karube

et al. 2023

Int J Case Rep Images

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Introduction: Although laryngeal abscess is a rare disease in this day when antibiotics and vaccines are widely available, it can be fatal in terms of choking risk due to airway narrowing and thus requires an immediate diagnosis and treatment, including airway management. Even in the field of oral surgery, where nasogastric tubes are often used for nutritional management, there have been no reports of laryngeal abscesses. Case Report: One month after right maxillary gingival carcinoma surgery, a 72-year-old man had hoarseness and a fever following nasogastric tube replacement, and blood tests showed a marked increase in inflammatory levels. The patient started chemotherapy with SBT/ABPC (12 g/day). Contrast-enhanced magnetic resonance imaging showed a low-density area with a rim enhancement effect from the left laryngeal surface of the epiglottis to the left supraglottis, which had caused airway narrowing, leading to a diagnosis of laryngeal abscess. Considering the risk of airway obstruction, a tracheostomy was performed under general anesthesia. On day 16, contrast-enhanced computed tomography showed a reduction in the lesion size. On day 36, antibiotic chemotherapy was terminated. At 10 months after surgery, lung metastasis developed without local or cervical recurrence, and chemotherapy was off-label due to his worsening renal function. Therefore, the best supportive care policy was selected. The patient’s general condition gradually deteriorated, and he died 11 months after the surgery. Conclusion: There are very few reports related to nasogastric tubes, so it is necessary to keep the disease concept of laryngeal abscess in mind, especially in the field of oral surgery, where nasogastric tubes are often used for nutritional management.

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Section: Discussionmentioning

confidence: 80%

Laryngeal abscess formation secondary to utilization of nasogastric tube in oral cancer patient: A case report

Nishi,

Yamada,

Karube

et al. 2023

Int J Case Rep Images

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“…There were 7 cases of spontaneous laryngeal abscess identified in the literature since 1985. [7][8][9][10][11][12][13] In total, 8 cases (inclusive of current case) are included for analysis. Six of 8 had some form of immunocompromise (75%).…”

Section: Resultsmentioning

confidence: 99%

Historical Review and Modern Case of Spontaneous Laryngeal Abscess

Rohlfing

Kan

Tierney

et al. 2022

Ann Otol Rhinol Laryngol

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Objective: Laryngeal abscesses are rare in the modern antibiotic era. Historically, they were associated with systemic infections including typhoid fever, measles, gonorrhea, syphilis, and tuberculosis. More recent authors have described cases resulting from iatrogenic injury and immunosuppression. This report presents a novel case of laryngeal abscess in the setting of uncontrolled diabetes and a detailed review of modern, reported cases of spontaneous laryngeal abscess. Methods: Report of a single case. Also, PubMed was queried for cases of laryngeal abscess since 1985. Case report: A 58-year-old male with poorly controlled diabetes presented with odynophagia, dysphagia, and dyspnea. He had biphasic stridor, and flexible laryngoscopy showed reduced mobility of bilateral vocal folds and narrowed glottic airway. He was taken urgently for awake tracheostomy and microdirect laryngoscopy. Laryngoscopy demonstrated fullness and fluctuance of the right hemilarynx. The abscess cavity was entered endoscopically via paraglottic incision extending into the subglottis. The patient was treated with an 8-week course of ampicillin-sulbactam with resolution of infection. Results: Seven additional cases of spontaneous laryngeal abscesses published after 1985 were identified. In total, 6 of 8 had some form of immunodeficiency (75%). The most common presenting symptoms were dysphonia (8/8, 100%), odynophagia (5/8, 62.5%), and dyspnea/stridor (4/8, 50%). All cases were treated with surgical incision and drainage. Conclusions: Laryngeal abscesses are rare in the era of modern antibiotics. This review confirms that the majority of recent episodes occurred in the setting of immunodeficiency and are caused by non-tubercular bacteria. These infections are commonly associated with impaired vocal fold mobility which may contribute to dyspnea, stridor, and airway compromise. Surgical intervention is necessary for treatment and culture-directed antimicrobial therapy. Poorly controlled diabetes is a newly described context for development of spontaneous laryngeal abscess.

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Larynx Lesions

Dong

Lyu²

2022

Radiology of Infectious and Inflammatory Diseases - Volume 2

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Laryngeal abscess formation in an immunosuppressed patient: A case report

Cited by 5 publications

References 10 publications

Laryngeal abscess formation secondary to utilization of nasogastric tube in oral cancer patient: A case report

Laryngeal abscess formation secondary to utilization of nasogastric tube in oral cancer patient: A case report

Historical Review and Modern Case of Spontaneous Laryngeal Abscess

Larynx Lesions

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