Parthasarathy Vishnu, Snyder Brian, Saddawi-Konefka Robert
University of California San Diego, San Diego, California.
J Emerg Med. 2018 Dec;55(6):841-844. doi: 10.1016/j.jemermed.2018.09.017. Epub 2018 Oct 17.
In the winter months, one often sees a large increase in the volume of patients presenting to emergency departments with acute pharyngitis. While most cases of acute pharyngitis are benign, a rare minority can be life threatening.
We report a case of epiglottis with a concomitant peritonsillar abscess (PTA) in an adult who presented to the emergency department with a sore throat. Computed tomography (CT) scan showed epiglottitis with a developing left PTA. The patient was treated with broad-spectrum antibiotics, high-dose steroids, and underwent multiple laryngoscopies with eventual resolution of his epiglottic swelling. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case serves to highlight the importance of physical examination and CT imaging in identifying patients with pharyngitis who can benefit from additional interventions and monitoring. It is also an unusual example of the presence of two likely related upper respiratory pathologies presenting in the same patient.
在冬季，经常会看到急诊科因急性咽炎前来就诊的患者数量大幅增加。虽然大多数急性咽炎病例是良性的，但极少数可能危及生命。
我们报告一例成年患者，因咽痛到急诊科就诊，诊断为会厌炎合并扁桃体周围脓肿（PTA）。计算机断层扫描（CT）显示会厌炎伴左侧PTA形成。患者接受了广谱抗生素、大剂量类固醇治疗，并多次进行喉镜检查，会厌肿胀最终消退。急诊科医生为何应了解此病例？：该病例凸显了体格检查和CT成像在识别可从额外干预和监测中获益的咽炎患者中的重要性。这也是同一患者出现两种可能相关的上呼吸道病变的罕见例子。
