Large Retropharyngeal Abscesses in an Immunocompetent Adult Patient with Disseminated Tuberculosis
| Autor: | Arturo Rodríguez-Toledo, Gerardo Amaya-Tapia, Sergio Aguilar-Benavides, Guadalupe Aguirre-Avalos |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Tuberculosis Tuberculosis Lymph Node Mycobacterium tuberculosis 03 medical and health sciences 0302 clinical medicine medicine 030212 general & internal medicine 030223 otorhinolaryngology Abscess Retropharyngeal space biology business.industry Pharynx Retropharyngeal abscess General Medicine Articles medicine.disease biology.organism_classification bacterial infections and mycoses Retropharyngeal Abscess Dysphagia Surgery medicine.anatomical_structure Etiology medicine.symptom business |
| Zdroj: | The American Journal of Case Reports |
| ISSN: | 1941-5923 |
| Popis: | Patient: Male, 46 Final Diagnosis: Generalized tuberculous lymphadenitis with retropharyngeal abscesses and disseminated tuberculosis Symptoms: Lymphadenopathy • dysphagia • weight loss Medication: — Clinical Procedure: — Specialty: Infectious Diseases Objective: Unusual clinical course Background: The retropharyngeal abscess is a rare presentation of head and neck tuberculosis. The pathogenesis of the abscess formation in the retropharyngeal space in the adult is controversial. Case Report: We report a case of large retropharyngeal abscesses in a 46-year-old man with disseminated tuberculosis. The patient had severe progressive dysphagia, weight loss, and a slowly enlarging bilateral cervical mass during a period of three months. His posterior pharynx wall was bulging and red, and both tonsils were enlarged and congested. The neck had an abscess of 5 cm in diameter that was firm, tender, and warm along the left sternocleidomastoid muscle. Palpable bilateral lymphadenitis was detected in the submandibular, cervical, axillary, and inguinal regions. A computed tomographic (CT) scan of the neck revealed large bilobulated retropharyngeal abscesses. A liver ultrasound showed multiple hypoechoic lesions. A Ziehl-Neelsen smear for acid-fast bacilli was positive from different abscess samples, and mycobacterial cultures subsequently yielded Mycobacterium tuberculosis. Antituberculous therapy was begun and the retropharyngeal abscesses were aspirated by external incision with complete drainage and relief of symptoms. Conclusions: Large retropharyngeal abscess is a rare entity in which Mycobacterium tuberculosis etiology should be considered, especially in endemic countries, and the diagnosis may be difficult because symptoms and signs are influenced by abscess size and time of onset, or if the etiology is not suspected. |
| Databáze: | OpenAIRE |
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