Spontaneous <scp>MRSA</scp> postcricoid abscess: A case report and literature review

Boyce, Brian; deSilva, Brad W.

doi:10.1002/lary.24819

Cited by 11 publications

(5 citation statements)

References 12 publications

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“…Previous work has shown that the diagnosis of MRSA laryngitis can be confirmed with in‐office or operating room (OR) biopsy and culture of the true vocal fold tissue . Currently, only eight cases of MRSA laryngitis have been reported in the literature, but evidence suggests an increasing incidence …”

Section: Introductionmentioning

confidence: 99%

“…4,10 Currently, only eight cases of MRSA laryngitis have been reported in the literature, but evidence suggests an increasing incidence. 3,4,10,11 Our experience in the voice disorders clinic at a tertiary care hospital is that the symptoms of laryngeal MRSA infections are subtle in comparison to typical MRSA infections seen elsewhere in the body. 12 The objective of the study at hand was to assess the incidence in MRSA laryngitis in our patient population with chronic bacterial laryngitis, evaluate potential risk factors, and help create a treatment algorithm that may be used in the management of this growing problem.…”

Section: Introductionmentioning

confidence: 99%

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MRSA chronic bacterial laryngitis: A growing problem

Carpenter

Kendall

2017

The Laryngoscope

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

MRSA chronic bacterial laryngitis: A growing problem

Carpenter

Kendall

2017

The Laryngoscope

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“…Despite the fact that pharyngalgia and odynophagia were the most frequently reported presenting symptoms in our patient group, only respiratory distress and muffled voice demonstrated a correlation between AE and EA formation. 26 Similarly, Kim et al 23 reported that muffled voice was present in 29% of AE patients and 64% of EA patients in a series of 90 patients. Dyspnea was present in 14% and 36% of participants, respectively.…”

Section: Discussionmentioning

confidence: 93%

Clinical and Microbiological Factors Associated With Abscess Formation in Adult Acute Epiglottitis

Sideris

Papadimitriou

Korres

et al. 2021

Ann Otol Rhinol Laryngol

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Objectives: To evaluate clinical and microbiological findings that are correlated with abscess formation in adult acute epiglottitis (AE). Methods: We reviewed 140 cases of adult AE. Demographic, clinical, imaging, and microbiological findings are analyzed for all patients with AE in comparison to those with epiglottic abscess (EA). Results: A total of 113 patients presented with AE and 27 presented or progressed to EA (19.3%). Age, sex, seasonality, smoking, body mass index (BMI), and comorbidities were statistically insignificant between the 2 groups. Muffled voice ( P < .013), respiratory distress ( P < .001), and pre-existence of epiglottic cyst ( P < .001) are symptoms and signs connected with abscess formation. A total of 120 patients were treated conservatively. Surgical treatment was performed on 20 patients with EA. About 72 out of 80 cultures revealed monomicrobial infection. Mixed flora was isolated in 8 patients with EA. Streptococcus was isolated in 51 out of 80 positive cultures (64%). Haemophilus Influenza ( Hib) was not isolated in any sample. EA and mixed flora relates to a higher rate of airway intervention ( P < .001). Conclusion: A high level of suspicion for abscess formation is required if clinical examination reveals dyspnea, muffled voice, or an epiglottic cyst in adult with AE. The existence of EA doubles the duration of hospitalization. EA is typically found on the lingual surface of the epiglottis. Supraglottic or deep neck space expansion should be treated surgically. EA is associated with a mixed flora and a higher rate of airway obstruction. Streptococcus is discovered to be the most common pathogen.

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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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Spontaneous MRSA postcricoid abscess: A case report and literature review

Cited by 11 publications

References 12 publications

MRSA chronic bacterial laryngitis: A growing problem

MRSA chronic bacterial laryngitis: A growing problem

Clinical and Microbiological Factors Associated With Abscess Formation in Adult Acute Epiglottitis

Historical Review and Modern Case of Spontaneous Laryngeal Abscess

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