Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.
East Carolina Anesthesia Associates, Greenville, North Carolina, USA.
Cancer Rep (Hoboken). 2023 Mar;6(3):e1783. doi: 10.1002/cnr2.1783. Epub 2023 Jan 23.
Patients undergoing chemotherapy and radiotherapy are placed in an immunocompromised state worth consideration in the event of potential airway compromise, especially when superimposed on an airway-obstructing tumor. We report a case of bacterial epiglottitis in a patient with active oropharyngeal cancer (OPC), who presented in such a way that an infectious etiology was not initially considered in the patient's care. To our knowledge, such a circumstance has not been reported in the literature.
Here, we report a case of a 68-year-old male with advanced-stage OPC who developed respiratory distress and underwent emergent tracheostomy. The patient was diagnosed postoperatively with Haemophilus influenza and Pseudomonas aerugeniosa. Following antibiotic treatment, the patient recovered to the point in which he could then undergo concomitant chemoradiation. The patient later had a recurrence of P. aerugeniosa during their radiotherapy that was also treated with antibiotics. The patient experienced continued symptoms related to their OPC and underwent pharyngectomy. Despite the initial success of this procedure, the patient experienced tumor recurrence and succumbed to his disease.
This case underscores the importance of considering multiple etiologies concerning airway compromise, as the consequence of delayed cancer treatment may be loss of local cancer control.
接受化疗和放疗的患者处于免疫功能低下状态,在潜在气道阻塞的情况下值得考虑,尤其是在气道阻塞性肿瘤的基础上。我们报告了一例活动性口咽癌(OPC)患者发生细菌性会厌炎的病例,该患者的临床表现最初并未考虑感染性病因。据我们所知,这种情况在文献中尚未报道过。
在此,我们报告一例 68 岁男性,患有晚期 OPC,出现呼吸窘迫并接受紧急气管切开术。术后诊断为流感嗜血杆菌和铜绿假单胞菌感染。经过抗生素治疗,患者恢复到可以同时接受放化疗的状态。患者在放疗过程中再次发生铜绿假单胞菌感染,也接受了抗生素治疗。患者持续存在与 OPC 相关的症状,并接受了咽切除术。尽管该手术最初取得了成功,但患者出现肿瘤复发并最终死于该疾病。
该病例强调了考虑多种病因引起气道阻塞的重要性,因为癌症治疗的延迟可能导致局部癌症控制的丧失。