Upper Airway Obstruction in Infectious Mononucleosis

1980 ◽  
Vol 89 (5) ◽  
pp. 430-433 ◽  
Author(s):  
Judith A. Wolfe ◽  
Lee D. Rowe
Keyword(s):  
Airway Obstruction ◽  
Infectious Mononucleosis ◽  
Upper Airway ◽  
Lymphoid Hyperplasia ◽  
Unusual Complication ◽  
Recent Experience ◽  
Respiratory Obstruction ◽  
Swallowing Function ◽  
Bulbar Paralysis ◽  
Upper Respiratory

Life-threatening upper respiratory obstruction is an unusual complication of infectious mononucleosis. Although the majority of fatalities result from progressive bulbar paralysis or the Guillain-Barré syndrome, airway impairment primarily occurs as a result of pharyngeal lymphoid hyperplasia and associated faucial arch edema. Recent experience in a young child with infectious mononucleosis who exhibited progressive hypersomnolence, sleep apnea, and stridor during sleep is presented. In addition, a retrospective analysis of 72 cases of respiratory complications of infectious mononucleosis provides guidelines for specific airway management. Mild upper respiratory obstruction with persistent fever, severe odynophagia, and malaise is treated with parenteral corticosteroids. Immediate tonsillectomy using a halothane and oxygen induction technique is recommended for severe airway occlusion. Tracheotomy is currently reserved for those patients with progressive alveolar hypoventilation, hypercarbia, atelectasis, and bulbar paralysis. In general, tonsillectomy is well-tolerated, eliminating airway obstruction, improving swallowing function, and rapidly resolving pharyngeal discomfort.

scholarly journals Tracheal perforation managed by temporary tracheostomy in a horse : clinical communication

2005 ◽  
Vol 76 (2) ◽  
Author(s):  
M.N. Saulez ◽  
N.M. Slovis ◽  
A.T. Louden
Keyword(s):  
Airway Obstruction ◽  
Conservative Management ◽  
Local Anaesthesia ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Cervical Region ◽  
Respiratory Obstruction ◽  
Clinical Communication ◽  
Severe Emphysema ◽  
Upper Respiratory

Tracheal trauma with resultant rupture is uncommonly reported in veterinary literature. We report the case of a 16-year-old Thoroughbred gelding that sustained a 1 cm longitudinal perforation of the dorsal tracheal membrane in the proximal cervical region. The horse subsequently developed dyspnoea due to acute upper respiratory obstruction secondary to severe emphysema of the guttural pouches. A temporary tracheostomy caudal to the site of tracheal perforation was performed under local anaesthesia. This procedure helped relieve the upper airway obstruction and aided resolution of the injury by diverting air away from the site of tracheal perforation. After conservative management, the gelding recovered completely.

Acute tonsillectomy in the management of infectious mononucleosis

1992 ◽  
Vol 106 (11) ◽  
pp. 989-991 ◽  
Author(s):  
D. S. Stevenson ◽  
G. Webster ◽  
I. A. Stewart
Keyword(s):  
Airway Obstruction ◽  
Infectious Mononucleosis ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Respiratory Obstruction ◽  
Recurrent Tonsillitis ◽  
Emergency Tracheostomy ◽  
Life Threatening

AbstractLife-threatening upper airway obstruction can be caused by tonsillopharyngitis secondary to infectious mononucleosis (IM). The administration of corticosteroids, emergency tracheostomy and acute tonsillectomy have been advocated as ways of managing this problem. In a series of 25 patients admitted over a five-year period with IM, 15 were judged to have symptoms severe enough to warrant the administration of corticosteroids. Six of these 15 patients had little improvement in their condition and thus underwent acute tonsillectomy. There were no significant complications of this surgery. A further three patients who received corticosteroids required tonsillectomy for recurrent tonsillitis later in the study period. By contrast, only one of the ten patients who did not receive corticosteroids subsequently required tonsillectomy. Acute tonsillectomy is of value in selected cases of IM tonsillopharyngitis. It may decrease the morbidity of recurrent tonsillitis after IM, in addition to averting the immediate risk of respiratory obstruction.

1. Fatal Acute Hepatitis in Infectious Mononucleosis in a Forensic Setting

2005 ◽  
Vol 45 (3) ◽  
pp. 261-264 ◽  
Author(s):  
Anny Sauvageau ◽  
Stéphanie Racette
Keyword(s):  
Acute Hepatitis ◽  
Infectious Mononucleosis ◽  
Splenic Rupture ◽  
Upper Airway ◽  
Neurological Complications ◽  
Bleeding Complications ◽  
Respiratory Obstruction ◽  
First Case ◽  
Secondary Infections ◽  
Forensic Setting

Mononucleosis is generally considered a benign, self-limited disease. However, though uncommon, fatal complications are sometimes encountered. Deaths from liver failure, splenic rupture, respiratory obstruction, neurological complications, secondary infections and bleeding complications have been described. In the forensic setting, there are a few reports of sudden and unexplained deaths from splenic rupture and upper airway obstruction. We report here the first case of sudden and unexplained death from acute hepatitis in infectious mononucleosis presenting as a suspicious death.

Parapharyngeal cerebrospinal fluid collection: an unusual complication of temporal bone fracture

2010 ◽  
Vol 125 (3) ◽  
pp. 321-323
Author(s):  
C Kirton ◽  
A Guidera
Keyword(s):  
Cerebrospinal Fluid ◽  
Literature Review ◽  
Airway Obstruction ◽  
Temporal Bone ◽  
Bone Fracture ◽  
Fluid Collection ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Unusual Complication ◽  
Temporal Bone Fracture

AbstractObjective:We present an unusual case of parapharyngeal cerebrospinal fluid collection causing upper airway obstruction following a temporal bone fracture.Method:Case report and literature review of temporal bone fracture associated with parapharyngeal cerebrospinal fluid collection.Results:A 19-year-old man presented with cerebrospinal fluid otorrhoea and temporal bone fracture following a head injury. He was discharged after 48 hours of observation. The patient returned within 6 hours with sudden unilateral neck swelling and stridor after blowing his nose. Flexible nasendoscopy and computed tomography showed extrinsic compression of the pharynx, with partial upper airway obstruction. A literature review using Pubmed™ and Medline™ identified no previously reported cases of parapharyngeal cerebrospinal fluid collection associated with temporal bone fracture.Conclusion:This case illustrates a previously undescribed complication of temporal bone fracture. Raised intracranial pressure in the presence of a cerebrospinal fluid fistula may lead to airway obstruction, following temporal bone fracture.

Nasopharyngeal airway for upper airway obstruction in infectious mononucleosis

2020 ◽  
Vol 62 (5) ◽  
pp. 642-643
Author(s):  
Hiroshi Fukumasa ◽  
Chiaki Tanaka ◽  
Masashi Kobayashi ◽  
Shunsuke Hayano ◽  
Masano Amamoto
Keyword(s):  
Airway Obstruction ◽  
Infectious Mononucleosis ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Nasopharyngeal Airway

Airway Obstruction in Children with Infectious Mononucleosis

1995 ◽  
Vol 74 (9) ◽  
pp. 630-638 ◽  
Author(s):  
Daniel L. Wohl ◽  
Jon E. Isaacson
Keyword(s):  
Airway Obstruction ◽  
Infectious Mononucleosis ◽  
Epstein Barr Virus ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Clinical Severity ◽  
Prolonged Intubation ◽  
Barr Virus ◽  
Inflammatory Edema ◽  
Epstein Barr

Epstein-Barr Virus (EBV) infection generally has a benign clinical course. Upper airway obstruction is a known complication requiring the otolaryngologist's attention. EBV is usually associated with adolescence but has been increasingly documented in younger children. We review 36 pediatric admissions for infectious mononucleosis over a 12-year period at our institution, 11 of which required consultation for airway obstruction. Airway management was based on clinical severity and ranged from monitored observation, with or without nasopharyngeal stenting, to prolonged intubation or emergent tonsilloadenoidectomy. A rare case of a four-year-old with near total upper airway obstruction secondary to panpharyngeal and transglottic inflammatory edema prompted this review and is reported. The otolaryngologist must recognize the potential severity of EBV-related airway compromise and be prepared to manage it.

Infectious mononucleosis complicated by lingual tonsillitis

1990 ◽  
Vol 104 (8) ◽  
pp. 651-653 ◽  
Author(s):  
Gady Har-El ◽  
Jordan S. Josephson
Keyword(s):  
Airway Obstruction ◽  
Infectious Mononucleosis ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Base Of Tongue ◽  
Lingual Tonsillitis

AbstractAlthough upper airway obstruction and superimposed infection are well-known complications of infectious mononucleosis, lingual tonsillitis in this context has not been mentioned in the literature. We describe a case of acute bacterial lingual tonsillitis with airway obstruction complicating infectious mononucleosis. The role of the base of tongue region in the pathophysiology of infectious mononucleosis is discussed.

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