Khoury Michel, Dong Selina Xiangxu, Alsaffar Hussain, Johnson-Obaseki Stephanie, Caulley Lisa
Department of Undergraduate Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
SAGE Open Med Case Rep. 2022 Apr 4;10:2050313X221089119. doi: 10.1177/2050313X221089119. eCollection 2022.
Pharyngeal abscesses require urgent management as they have the propensity to cause severe and life-threatening complications. The introduction of antibiotics has led to a dramatic decline in the incidence of these infections. Regardless, abscess formation continues to be observed in the peritonsillar, parapharyngeal, and retropharyngeal spaces. Oropharyngeal and hypopharyngeal abscesses that cause airway obstruction are scarcely reported and tend to be secondary to other processes. Herein, we describe the case of an 83-year-old man presenting with an idiopathic, obstructive, oropharyngeal wall abscess, extending from the infratonsillar region to the hypopharynx, which recurred after initial surgical management 12 years prior for the same process. He required reintervention during both episodes for rapid reaccumulation. A detailed electronic literature search of PubMed and MedLine was performed for studies reporting on recurrent pharyngeal abscesses and their management. Results were limited to articles published in English from inception to August 2021. The timely management of pharyngeal infections acutely obstructing the airway is crucial. Physicians should adopt close and frequent monitoring and have a low threshold for reimaging should symptoms worsen or fail to improve after the initial surgical intervention.
咽脓肿需要紧急处理，因为它们容易导致严重的、危及生命的并发症。抗生素的引入已使这些感染的发生率大幅下降。尽管如此，扁桃体周围、咽旁和咽后间隙仍继续出现脓肿形成。导致气道阻塞的口咽和下咽脓肿鲜有报道，且往往继发于其他疾病过程。在此，我们描述了一例83岁男性患者，其患有特发性、阻塞性口咽壁脓肿，从扁桃体下区域延伸至下咽，该患者在12年前曾因相同病情接受过初次手术治疗后复发。在两次发作期间，他均因脓肿迅速重新积聚而需要再次干预。我们对PubMed和MedLine进行了详细的电子文献检索，以查找关于复发性咽脓肿及其治疗的研究报告。结果仅限于从创刊至2021年8月以英文发表的文章。及时处理急性阻塞气道的咽部感染至关重要。医生应进行密切且频繁的监测，并且如果在初次手术干预后症状恶化或未改善，应保持较低的再次影像学检查阈值。
