Published online Nov 26, 2019. doi: 10.12998/wjcc.v7.i22.3838
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
Processing time: 116 Days and 16.8 Hours
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.
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.
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.
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.