Massive retropharyngeal lymphadenopathy in an infant: an unusual presentation of infectious mononucleosis

2004 ◽  
Vol 118 (12) ◽  
pp. 983-984 ◽  
Author(s):  
Sudhir Lobo ◽  
H. Williams ◽  
V. Singh
Keyword(s):  
Airway Obstruction ◽  
Infectious Mononucleosis ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Uneventful Recovery ◽  
Retropharyngeal Space ◽  
Upper Respiratory Tract ◽  
Barr Virus ◽  
Short Period ◽  
Epstein Barr

Infectious mononucleosis causing upper airway obstruction due to tonsillar disease and associated lymphadenopathy in adolescents is well recognized. However, infection with Epstein-Barr virus (EBV) in a young child of six months is rare. The authors present such a case, with massive swelling of the retropharyngeal lymph nodes, that has not been published previously. The patient presented to this department with a short history of an upper respiratory tract infection and mild upper airway obstruction. On examination there was a massive enlargement of the retropharyngeal space with a compromised airway. This was confirmed on X-ray. She made an uneventful recovery following incision and drainage and a short period of endotracheal intubation. Because of the presence of retropharyngeal lymphoid tissue in infancy an alternative site of upper airway obstruction may occur here in this age group.

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.

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

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.

scholarly journals Upper airway obstruction caused by primary lymphoplasmacytic lymphoma of the retropharyngeal space: a case report

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Chinyere N. Asoegwu ◽  
Okezie O. Kanu ◽  
Clement C. Nwawolo
Keyword(s):  
Lymph Nodes ◽  
Airway Obstruction ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Retropharyngeal Space ◽  
Histopathological Diagnosis ◽  
Lymphoplasmacytic Lymphoma ◽  
Malignant Tumours ◽  
Post Surgery ◽  
Emergency Tracheostomy

Abstract Background Primary malignant tumours of the retropharyngeal space are rare with only a few case reports in the literature. Lymphoplasmacytic lymphoma is a rare subtype of non-Hodgkin lymphoma and is very rarely found as a primary tumour of the retropharyngeal space. Case presentation We report the case of progressive upper airway obstruction in a 49-year-old male caused by a primary malignant tumour of the retropharyngeal space lymph nodes. He had an emergency tracheostomy to relieve the upper airway obstruction followed a week later by an elective surgical excision of the tumour via the trans-cervical route. A mixed population of lymphocytes, with a marked presence of Dutcher bodies, was noted on histopathology and positive CD20 on immunohistochemistry, confirming the lymphoplasmacytic lymphoma of the retropharyngeal space. The watchful waiting treatment method for the lymphoma was employed for him since he had no symptoms relating to lymphoma and no serum Waldenström’s macroglobulinemia. He has remained symptom-free 3 years post-surgery. Conclusion Primary malignant tumours involving the retropharyngeal space lymph nodes are very rare. They can rarely grow to a size huge enough to cause obstructive upper aerodigestive symptoms. Primary lymphoma of the retropharyngeal space should be considered in the diagnosis of the tumours involving the retropharyngeal space lymph nodes. Excisional biopsy is important to obtain tissue for histopathological diagnosis and the relief of upper aerodigestive tract obstruction when present.

Treatment of Posttransplant Lymphoproliferative Disorder Presenting as Protracted Infectious Mononucleosis with Rituximab

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4999-4999
Author(s):  
Alan Kwok Shing Chiang
Keyword(s):  
Airway Obstruction ◽  
Clinical Improvement ◽  
Infectious Mononucleosis ◽  
Lymphoproliferative Disorder ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Nuclear Antigen ◽  
Posttransplant Lymphoproliferative Disorder ◽  
Liver Transaminases ◽  
One Year

Abstract Two young children who received living related-donor orthotopic liver transplantation for congenital biliary atresia developed persistent and progressive symptoms of fever, hepatosplenomegaly, upper airway obstruction, swollen eyes and face, malaise and cervical lymphadenopathy consistent with infectious mononucleosis within one year post-transplantation. Significant anemia, elevated liver transaminases and hypergammaglobulinaemia were observed. Serological assays did not detect any antibodies to Epstein-Barr virus (EBV) pre-transplantation indicating seronegative status. Both patients showed recent seroconversion to EBV (viral capsid antigen IgM and IgG positive but EBV nuclear antigen negative) at the peak of the clinical symptoms. The diagnosis of primary EBV-driven posttransplant lymphoproliferative disorder (PTLD) was established. Lowering or withdrawal of tacrolimus for a period of 2–3 weeks did not lead to any discernible clinical improvement. Both children were treated with four weekly doses of rituximab of 375 mg/m2/dose. They developed infusion reaction of fever, vomiting and unstable blood pressure within half hour of first dose of rituximab requiring stoppage of the drug administration. Subsequent doses were tolerated much better without adverse events. Clinical improvement was gradually observed over the next few weeks with resolution of fever, upper airway obstruction, decreasing liver transaminases and improvement of general condition. Complete resolution of infectious mononucleosis and normalization of hematological and biochemical parameters was achieved over a period of 6 months. No recurrence of PTLD was observed up to one year after treatment with rituximab.

scholarly journals Cardiorespiratory evaluation of brachycephalic syndrome in dogs

2018 ◽  
Vol 38 (6) ◽  
pp. 1130-1136 ◽  
Author(s):  
Raphaela A.M. Canola ◽  
Marlos G. Sousa ◽  
Jaislane B. Braz ◽  
Wilmer Alejandro Z. Restan ◽  
Diego I. Yamada ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Clinical Manifestations ◽  
Upper Airway ◽  
Cor Pulmonale ◽  
Indirect Measurement ◽  
Upper Airway Obstruction ◽  
Control Group ◽  
Upper Respiratory Tract ◽  
Arterial Blood ◽  
A Prospective Study

ABSTRACT: Brachycephalic syndrome (BS) in dogs is characterized by the combination of primary and secondary upper respiratory tract abnormalities and may result in significant upper airway obstruction. It can trigger inspiratory dyspnea, culminating in secondary respiratory distress, soft tissue edema, upper airway obstruction, turbulent airflow, inspiratory noise, and even death. These changes lead to increased resistance of the air passages, which can cause elevation of pulmonary pressure and clinical manifestations attributable to pulmonary hypertension. The consequence is right-sided cardiac remodeling (Cor pulmonale) with possible progression to right congestive heart failure. To investigate the effects of BS on the cardiovascular system, 28 animals were recruited for a prospective study and assigned to either the Brachycephalic Group (BG), composed of 22 French bulldogs with BS or the Control Group (CG), which was composed of 6 healthy Beagle dogs. All animals underwent a detailed physical examination, as well as laboratory analyses, electrocardiography, echocardiography, chest radiography and indirect measurement of systemic arterial blood pressure. The most relevant finding was a lower PaO2 (90.6±12.9mmHg) in BG as compared to CG (104.9±5.2), (p≤0.05), possibly attributable to hypoventilation due to anatomical alterations.

Laryngopharyngeal mucosal fold causing upper airway obstruction in a dog

2019 ◽  
Vol 7 (2) ◽  
pp. e000823
Author(s):  
Miles John Penfold ◽  
Johannes van der Zee ◽  
Marthinus Jacobus Hartman
Keyword(s):  
Airway Obstruction ◽  
Diode Laser ◽  
Tracheostomy Tube ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Uneventful Recovery ◽  
Laryngeal Oedema ◽  
First Report ◽  
Mucosal Fold

A 2.4-kg, six-year-old, sterilised, male Pomeranian presented with dyspnoea that had begun two years prior and slowly progressed. Pharyngoscopy identified a redundant laryngopharyngeal mucosal fold that was being aspirated cranially into the laryngeal opening causing upper airway obstruction. A diode laser was used to resect the fold. Postoperative laryngeal oedema necessitated the use of a tracheostomy tube for just over two days. Otherwise, the dog made an uneventful recovery. To the authors’ knowledge, this is the first report of a redundant laryngopharyngeal mucosal fold resulting in upper airway obstruction in a dog.

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