Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2019; 7(22): 3838-3843
Published online Nov 26, 2019. doi: 10.12998/wjcc.v7.i22.3838
Retropharyngeal abscess presenting as acute airway obstruction in a 66-year-old woman: A case report
Jian Lin, Xiao-Mai Wu, Jia-Xi Feng, Mei-Fang Chen
Jian Lin, Xiao-Mai Wu, Jia-Xi Feng, Mei-Fang Chen, Division of Pulmonary and Critical Care Medicine, Wenzhou Medical University Affiliated Taizhou Hospital, Linhai 317000, Zhejiang Province, China
Author contributions: Chen MF, Lin J, and Feng JX designed this case report; Lin J and Wu XM wrote the manuscript.
Informed consent statement: The patient provided informed written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Mei-Fang Chen, MD, Associate Chief Physician, Division of Pulmonary and Critical Care Medicine, Wenzhou Medical University Affiliated Taizhou Hospital, No. 150 Ximen Road, Linhai 317000, Zhejiang Province, China. chenmeifang1979@163.com
Telephone: +86-576-85199238
Received: August 1, 2019
Peer-review started: August 1, 2019
First decision: September 9, 2019
Revised: September 30, 2019
Accepted: October 5, 2019
Article in press: October 5, 2019
Published online: November 26, 2019
Abstract
BACKGROUND

Adult retropharyngeal abscess (RPA) is extremely rare, and most cases reported in the literature were related to tuberculous infection. We present a case of RPA with acute airway obstruction as the main manifestation in a 66-year-old woman that was considered to be non-tubercular suppurative inflammation in the retropharyngeal space.

CASE SUMMARY

A 66-year-old woman complaining of chills and fever was admitted to our hospital. She was initially diagnosed with an acute upper respiratory tract infection. She lost consciousness twice during hospitalization. She regained consciousness immediately upon emergency tracheal intubation. Acute upper airway obstruction was suspected as arterial blood gas analysis showed obvious acute retention of carbon dioxide before the second tracheal intubation. The diagnosis of RPA was confirmed by computed tomography and magnetic resonance imaging. Kocuria kristinae was isolated from blood samples taken from both hands. The patient recovered and was subsequently discharged after receiving antibiotic therapy together with surgical incision and drainage of the abscess.

CONCLUSION

Clinicians should be alert to the possibility of RPA in patients with acute airway obstruction. Surgical incision and drainage is an effective treatment for RPA.

Keywords: Retropharyngeal abscess, Airway obstruction, Kocuria kristinae, Intubation, Surgery, Case report

Core tip: Adult retropharyngeal abscess is extremely rare as degeneration of the lymph nodes in the retropharyngeal space occurs after the age of 5 years, and most adult retropharyngeal abscesses are related to cervical spine tuberculosis. In this case report, the patient was considered to have acute non-tubercular suppurative inflammation in the retropharyngeal space. The clinical course of the patient was not straightforward, in that the initial manifestation was acute upper airway obstruction and the diagnosis of retropharyngeal abscess was only confirmed after two tracheal intubations when relevant examinations were performed.