Stone C K, Thomas S H
Department of Emergency Medicine, East Carolina University School of Medicine, Greenville, NC 27858-4354, USA.
Eur J Emerg Med. 1994 Mar;1(1):37-41. doi: 10.1097/00063110-199403000-00009.
We report the case of a 23-year-old male who presented to the emergency department with severe upper airway obstruction resulting from infection of the palatine tonsils. Manifestations of tonsillar infection and airway obstruction included hoarseness and extreme difficulty breathing, severe sore throat and inability to swallow liquids or solids. Urgent otolaryngologic consultation was obtained, and the patient was taken directly to the operating suite for nasotracheal intubation with tracheostomy standby. The patient was maintained on broad-spectrum antibiotics and was discharged after a hospital course complicated by pulmonary oedema, tracheitis and difficulty weaning from the ventilator, requiring temporary tracheostomy. The Monospot test was negative for infection with the Epstein-Barr virus (EBV). We could find no previously reported cases of adults with severe palatine tonsillar-induced airway obstruction which was not due to infection with EBV (mononucleosis). The airway management of obstruction due to palatine tonsillar hypertrophy is discussed.
我们报告了一例23岁男性病例，该患者因腭扁桃体感染导致严重上呼吸道梗阻而就诊于急诊科。扁桃体感染和气道梗阻的表现包括声音嘶哑和极度呼吸困难、严重咽痛以及无法吞咽液体或固体。紧急获得了耳鼻喉科会诊，患者被直接送往手术室进行鼻气管插管，并做好气管切开的准备。患者接受了广谱抗生素治疗，在经历了因肺水肿、气管炎和脱机困难而导致的复杂住院过程后出院，期间需要临时气管切开。嗜异性凝集试验检测结果显示，该患者未感染EB病毒（EBV）。我们未发现之前有关于非EBV感染（单核细胞增多症）导致成人严重腭扁桃体引起气道梗阻的报道病例。本文讨论了腭扁桃体肥大所致梗阻的气道管理。
