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婴儿双侧扁桃体周围脓肿:一种不常见的咽痛表现

Bilateral Peritonsillar Abscess in an Infant: An Unusual Presentation of Sore Throat.

作者信息

Seerig Mariana Manzoni, Chueiri Letícia, Jacques Janaina, de Mello Maria Fernanda Piccoli Cardoso, da Silva Martin Batista Coutinho, Zatt Daniel Buffon, Cunha Rosana Cristine Otero, Maranhão Andre Souza de Albuquerque

机构信息

Department of Otolaryngology, Hospital Infantil Joana de Gusmão and Hospital Governador Celso Ramos, 152 Rui Barbosa St., 88025-301 Florianópolis, SC, Brazil.

Department of Otolaryngology, Hospital Infantil Joana de Gusmão, 152 Rui Barbosa St., 88025-301 Florianópolis, SC, Brazil.

出版信息

Case Rep Otolaryngol. 2017;2017:4670152. doi: 10.1155/2017/4670152. Epub 2017 Aug 21.

Abstract

INTRODUCTION

Peritonsillar abscess is considered a suppurative complication of acute tonsillitis. It is usually unilateral and clinically evident bilateral presentation is uncommon. The condition affects mainly children older than 10 years and young adults. Herein we present a rare case of bilateral peritonsillar abscess in an infant.

PRESENTATION OF CASE

A 1-year-old boy presented with a two-day history of worsening sore throat, loss of appetite, vomiting, and fever. Examination of the oral cavity and oropharynx revealed enlarged and inflamed tonsils and a bilaterally congested and bulging soft palate. CT scan confirmed the hypothesis of bilateral peritonsillar abscess. Antibiotic therapy was instituted and after 5 days only slight regression of swelling of the soft palate was observed. He underwent a surgical procedure for draining the abscesses. After the procedure, he presented good clinical and laboratory evolution and was discharged home.

DISCUSSION

Although peritonsillar abscesses are considered common complications of acute tonsillitis bilateral cases are extremely rare, especially in early childhood. The diagnosis is based on history and physical examination and the treatment remains controversial among otolaryngologists.

CONCLUSION

Bilateral peritonsillar abscess should be diagnosed and treated promptly and adequately to prevent respiratory obstruction and to avoid dissemination into the deep neck spaces.

摘要

引言

扁桃体周围脓肿被认为是急性扁桃体炎的化脓性并发症。它通常是单侧的,临床上双侧出现的情况并不常见。这种疾病主要影响10岁以上的儿童和年轻成年人。在此,我们报告一例婴儿双侧扁桃体周围脓肿的罕见病例。

病例介绍

一名1岁男孩出现咽痛加重、食欲不振、呕吐和发热两天的症状。口腔和口咽检查发现扁桃体肿大且发炎,双侧软腭充血、隆起。CT扫描证实了双侧扁桃体周围脓肿的诊断。开始使用抗生素治疗,5天后仅观察到软腭肿胀略有消退。他接受了脓肿引流手术。术后,他的临床和实验室检查结果良好,随后出院回家。

讨论

尽管扁桃体周围脓肿被认为是急性扁桃体炎的常见并发症,但双侧病例极为罕见,尤其是在幼儿期。诊断基于病史和体格检查,治疗在耳鼻喉科医生中仍存在争议。

结论

双侧扁桃体周围脓肿应及时、充分地诊断和治疗,以防止呼吸道阻塞,并避免扩散至颈部深部间隙。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/846b/5585563/e6db9872023e/CRIOT2017-4670152.001.jpg

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