Retropharyngeal Abscess Caused by Penicillium Marneffei: An Unusual Cause of Upper Airway Obstruction

1994 ◽  
Vol 110 (4) ◽  
pp. 445-446 ◽  
Author(s):  
Kwai Fu Ko
2018 ◽  
Author(s):  
Michael W. Chan ◽  
Suzanne M. Schmidt

Upper airway obstruction is a common reason that children present for emergency care, and causes range from simple and benign etiologies to life-threatening conditions requiring emergent intervention. Both congenital and acquired conditions can result in airway obstruction at various levels, and due to the high risk of acute decompensation associated with some of these conditions, rapid diagnosis and treatment are essential. This review covers assessment and stabilization, diagnosis, and treatment of foreign-body aspiration, croup, bacterial tracheitis, epiglottitis, peritonsillar abscess, and retropharyngeal abscess. Figures show a diagram of the pediatric airway, an anteroposterior radiograph of the neck demonstrating the characteristic “steeple sign” in croup, an algorithm for the treatment of croup, lateral radiographs demonstrating a thickened epiglottis, consistent with a diagnosis of epiglottitis,  and a widening of the prevertebral soft tissues of the neck, consistent with a diagnosis of retropharyngeal abscess. Tables list causes of upper airway obstruction by anatomic location, symptoms of upper airway obstruction by anatomic location, severity of croup, and microbiology of deep neck abscesses.   This review contains 5 figures, 13 tables, and 32 references Key words: Upper airway obstruction; Pediatric upper airway obstruction, Foreign-body aspiration, Croup, Bacterial tracheitis, Epiglottitis, Peritonsillar abscess, Retropharyngeal abscess, Stridor


2020 ◽  
pp. 4040-4048
Author(s):  
James H. Hull ◽  
Matthew Hind

The upper airway is anatomically defined by the carina inferiorly and pharynx superiorly, with pathology predominately arising from the trachea and larynx. Obstruction of the upper airway may arise because of a fixed structural pathology such as tracheal stenosis or malignancy, but can arise following loss of normal function (e.g. inappropriate vocal cord adduction). A high index of suspicion is required to make the diagnosis because the clinical features of upper airway obstruction can mimic other respiratory conditions. Calculation of the ratio of forced expiratory volume in one second to peak expiratory flow (Empey index) may identify patients with unsuspected upper airway obstruction. Acute upper airway obstruction is a medical emergency and usually caused by aspiration, oedema (allergic, hereditary, and acquired angio-oedema, smoke inhalation), or infection (croup, epiglottitis, quinsy, retropharyngeal abscess). Non-acute causes of upper airway obstruction include malignancy, tracheal stenosis, tracheal compression, dynamic large airway collapse, and laryngeal dysfunction.


2018 ◽  
Author(s):  
Michael W. Chan ◽  
Suzanne M. Schmidt

Upper airway obstruction is a common reason that children present for emergency care, and causes range from simple and benign etiologies to life-threatening conditions requiring emergent intervention. Both congenital and acquired conditions can result in airway obstruction at various levels, and due to the high risk of acute decompensation associated with some of these conditions, rapid diagnosis and treatment are essential. This review covers assessment and stabilization, diagnosis, and treatment of foreign-body aspiration, croup, bacterial tracheitis, epiglottitis, peritonsillar abscess, and retropharyngeal abscess. Figures show a diagram of the pediatric airway, an anteroposterior radiograph of the neck demonstrating the characteristic “steeple sign” in croup, an algorithm for the treatment of croup, lateral radiographs demonstrating a thickened epiglottis, consistent with a diagnosis of epiglottitis,  and a widening of the prevertebral soft tissues of the neck, consistent with a diagnosis of retropharyngeal abscess. Tables list causes of upper airway obstruction by anatomic location, symptoms of upper airway obstruction by anatomic location, severity of croup, and microbiology of deep neck abscesses.   This review contains 5 figures, 13 tables, and 32 references Key words: Upper airway obstruction; Pediatric upper airway obstruction, Foreign-body aspiration, Croup, Bacterial tracheitis, Epiglottitis, Peritonsillar abscess, Retropharyngeal abscess, Stridor


1993 ◽  
Vol 14 (1) ◽  
pp. 19-29
Author(s):  
Joseph R. Custer

The airway of children is vital, but easily obstructed because it is narrow. Although there are many potential causes of upper airway obstruction (Table 1), a few diagnoses predominate. For example, in one study of 322 children presenting with stridor, 89% of cases were caused by croup, 8% by epiglottitis, and 2% by nonbacterial tracheitis.1 This review will cover these common airway infections as well as obstruction caused by inhalation of foreign bodies, spasmodic croup, and retropharyngeal abscess. Each of these diseases can progress to critical airway obstruction and hypoxia, causing organ damage or death. Individuals caring for children must be prepared to diagnose and treat airway emergencies expeditiously. Appropriate management of acute upper airway obstruction tests the organization of emergency care systems. Successful management of airway emergencies requires a team approach, including the skills of the primary physician and the staff of the emergency department, radiology department, and operating room (eg, anesthesiologist, otolaryngologist). Management of these cases can be anticipated, and prospective protocols can and should be established. Regional intensive care units, transport teams, emergency room personnel, primary care physicians, anesthesiologists, and otolaryngologists can agree on a prospective management scheme such as that outlined in Table 2. The issue of airway protection prior to or during transport to a tertiary care institution is controversial.


2018 ◽  
Author(s):  
Michael W. Chan ◽  
Suzanne M. Schmidt

Upper airway obstruction is a common reason that children present for emergency care, and causes range from simple and benign etiologies to life-threatening conditions requiring emergent intervention. Both congenital and acquired conditions can result in airway obstruction at various levels, and due to the high risk of acute decompensation associated with some of these conditions, rapid diagnosis and treatment are essential. This review covers assessment and stabilization, diagnosis, and treatment of foreign-body aspiration, croup, bacterial tracheitis, epiglottitis, peritonsillar abscess, and retropharyngeal abscess. Figures show a diagram of the pediatric airway, an anteroposterior radiograph of the neck demonstrating the characteristic “steeple sign” in croup, an algorithm for the treatment of croup, lateral radiographs demonstrating a thickened epiglottis, consistent with a diagnosis of epiglottitis,  and a widening of the prevertebral soft tissues of the neck, consistent with a diagnosis of retropharyngeal abscess. Tables list causes of upper airway obstruction by anatomic location, symptoms of upper airway obstruction by anatomic location, severity of croup, and microbiology of deep neck abscesses.   This review contains 5 figures, 10 tables, and 32 references Key words: Upper airway obstruction; Pediatric upper airway obstruction, Foreign-body aspiration, Croup, Bacterial tracheitis, Epiglottitis, Peritonsillar abscess, Retropharyngeal abscess, Stridor  


2016 ◽  
Vol 1 (3) ◽  
pp. 201
Author(s):  
Irsan Kurniawan ◽  
Agus Nurwiadh ◽  
Kiki Lukman

Left untreated or not properly managed odontogenic infection can cause spreading into facial spaces. Severe oral and maxillofacial infection can spread systemically and cause sepsis.1 Sepsis can induce unfavorable condition for the kidney, which is Acute Kidney Injury (AKI).2,3 The aim of this paper is to report a rare case of an oral and maxillofacial  infection with sepsis-induced AKI and upper airway obstruction which have high mortality rate. The standard treatment consists of proper monitoring of vital function, fluid resuscitation, drainage of accumulated purulence, empirical use of antibiotics chosen to cover the spectrum of potential pathogens until culture results are available, and supplemental oxygen.1,4 This is a case report of  a 48 year old female patient with oral and maxillofacial infection suffers sepsis-induced AKI and upper airway  obstruction. This patient was diagnosed as right submandibular abscess  which has extended into right buccal space, with sepsis, stage I AKI, and upper airway obstruction due to retropharyngeal abscess. We managed this patient with oxygenation, fluid resuscitation, antibiotics and analgesic administration, incision and drainage, and also extraction of mandibular right third molar. Tracheostomy, incision and drainage of retropharyngeal abscess were supposed to be performed by ENT department, but the patient refused. However the patient still survived. In case of oral and maxillofacial infection, the involvement of distant organ should be investigated, because this conditions result in high mortality rate. Early diagnosis and prompt treatment are important and able to lead to a better survival. 


2018 ◽  
Author(s):  
Michael W. Chan ◽  
Suzanne M. Schmidt

Upper airway obstruction is a common reason that children present for emergency care, and causes range from simple and benign etiologies to life-threatening conditions requiring emergent intervention. Both congenital and acquired conditions can result in airway obstruction at various levels, and due to the high risk of acute decompensation associated with some of these conditions, rapid diagnosis and treatment are essential. This review covers assessment and stabilization, diagnosis, and treatment of foreign-body aspiration, croup, bacterial tracheitis, epiglottitis, peritonsillar abscess, and retropharyngeal abscess. Figures show a diagram of the pediatric airway, an anteroposterior radiograph of the neck demonstrating the characteristic “steeple sign” in croup, an algorithm for the treatment of croup, lateral radiographs demonstrating a thickened epiglottis, consistent with a diagnosis of epiglottitis,  and a widening of the prevertebral soft tissues of the neck, consistent with a diagnosis of retropharyngeal abscess. Tables list causes of upper airway obstruction by anatomic location, symptoms of upper airway obstruction by anatomic location, severity of croup, and microbiology of deep neck abscesses.   This review contains 5 figures, 13 tables, and 32 references Key words: Upper airway obstruction; Pediatric upper airway obstruction, Foreign-body aspiration, Croup, Bacterial tracheitis, Epiglottitis, Peritonsillar abscess, Retropharyngeal abscess, Stridor


2018 ◽  
Author(s):  
Michael W. Chan ◽  
Suzanne M. Schmidt

Upper airway obstruction is a common reason that children present for emergency care, and causes range from simple and benign etiologies to life-threatening conditions requiring emergent intervention. Both congenital and acquired conditions can result in airway obstruction at various levels, and due to the high risk of acute decompensation associated with some of these conditions, rapid diagnosis and treatment are essential. This review covers assessment and stabilization, diagnosis, and treatment of foreign-body aspiration, croup, bacterial tracheitis, epiglottitis, peritonsillar abscess, and retropharyngeal abscess. Figures show a diagram of the pediatric airway, an anteroposterior radiograph of the neck demonstrating the characteristic “steeple sign” in croup, an algorithm for the treatment of croup, lateral radiographs demonstrating a thickened epiglottis, consistent with a diagnosis of epiglottitis,  and a widening of the prevertebral soft tissues of the neck, consistent with a diagnosis of retropharyngeal abscess. Tables list causes of upper airway obstruction by anatomic location, symptoms of upper airway obstruction by anatomic location, severity of croup, and microbiology of deep neck abscesses.   This review contains 5 figures, 13 tables, and 32 references Key words: Upper airway obstruction; Pediatric upper airway obstruction, Foreign-body aspiration, Croup, Bacterial tracheitis, Epiglottitis, Peritonsillar abscess, Retropharyngeal abscess, Stridor


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