1/43. Inflammatory subluxation of the atlantoaxial joint.A case of atlantoaxial subluxation accompanying pharyngitis is reported in a 4-year-old child. diagnosis was made by examination and roentgenograms of the lateral cervical spine. Treatment consisted of halter traction and bracing. The patient responded well to treatment and is normal in all respects one year later. Atlantoaxial subluxation should be considered when treating pharyngitis, especially if the patient presents with torticollis.- - - - - - - - - - ranking = 1keywords = tract (Clic here for more details about this article) |
2/43. angioedema presenting in the retropharyngeal space in an adult.PURPOSE: Hereditary angioedema is a rare disorder of deficient or dysfunctional C1-esterase inhibitor and usually manifests as edema of the face, tongue, supraglottis, extremities, or gastrointestinal tract. We report the case of a 40-year-old man with known hereditary angioedema who presented with a sore throat and a sensation of evolving airway obstruction. After a thorough search of the medical literature, we believe this to be the first reported case of angioedema manifesting in the retropharyngeal space. The pathophysiological factors of angioedema are discussed, along with its variable presentation and management issues. METHOD: Laryngoscopic examination was suggestive of posterior pharyngeal fullness; therefore, a computed tomographic scan of the neck was obtained, which showed a non-contrast-enhancing retropharyngeal edema from the base of the skull to below the level of the glottis. The patient had a history of multiple episodes of angioedema requiring hospitalization and three prior tracheotomies. RESULTS: Familiarity with the patient's history directed his rapid treatment course (including intravenous stanozolol, Solu-Medrol, and diphenhydramine), which significantly reduced his edema and avoided the need for tracheotomy. CONCLUSION: Hereditary angioedema may present in atypical locations, and expeditious treatment in a patient with a known history may avert the sequelae of evolving airway obstruction.- - - - - - - - - - ranking = 1keywords = tract (Clic here for more details about this article) |
3/43. Plasma cell mucositis: a review and case report.The simultaneous involvement of the mucous membranes of the oral cavity and upper aerodigestive tract by lesions characterised clinically by an intensely erythematous, lobulated surface and histologically by a dense connective tissue infiltrate composed of non-neoplastic plasma cells may be called plasma cell mucositis. We present a review of the literature, consisting of 14 cases, outlining the multifocal site distribution, chronicity and systemic background that distinguish this entity and report a single case with confirmation of the polyclonal nature of the plasma cell infiltrate using gene rearrangement studies.- - - - - - - - - - ranking = 1.3433756766013keywords = tract, upper (Clic here for more details about this article) |
4/43. Group A streptococcus causing PID from an initial pharyngeal infection. A case report.BACKGROUND: pelvic inflammatory disease (PID) is a difficult diagnosis. Five billion dollars is spent on over 1 million women diagnosed each year. Atypical organisms and prior history of tubal ligation may complicate the diagnosis. CASE: A woman who had undergone tubal ligation and abstained from intercourse for over two years developed group A streptococcal salpingitis. It occurred following an upper respiratory infection with the same organism. CONCLUSION: PID is rare in a woman with prior tubal ligation who is not engaging in intercourse. In this case it followed an upper respiratory infection with group A streptococcus. Low diagnostic suspicion must be maintained for uncommon pathogens in PID in women with prior tubal ligation who are not engaging in intercourse.- - - - - - - - - - ranking = 0.68675135320258keywords = upper (Clic here for more details about this article) |
5/43. Endovascular occlusion of a carotid pseudoaneurysm complicating deep neck space infection in a child. Case report.Pseudoaneurysm formation of the cervical internal carotid artery (ICA) is a rare, potentially lethal complication of deep neck space infection. This entity typically occurs following otolaryngological or upper respiratory tract infection. The pseudoaneurysm is heralded by a pulsatile neck mass, Homer's syndrome, lower cranial neuropathies, and/or hemorrhage that may be massive. The recommended treatment includes prompt arterial ligation. The authors present a case of pseudoaneurysm of the cervical ICA complicating a deep neck space infection. A parapharyngeal staphylococcus aureus abscess developed in a previously healthy 6-year-old girl after she experienced pharyngitis. The abscess was drained via an intraoral approach. On postoperative Day 3, the patient developed a pulsatile neck mass, lethargy, ipsilateral Horner's syndrome, and hemoptysis, which resulted in hemorrhagic shock. Treatment included emergency endovascular occlusion of the cervical ICA and postembolization antibiotic treatment for 6 weeks. The patient has made an uneventful recovery as of her 18-month follow-up evaluation. Conclusions drawn.from this experience and a review of the literature include the following: 1) mycotic pseudoaneurysms of the carotid arteries have a typical clinical presentation that should enable timely recognition; 2) these lesions occur more commonly in children than in adults; 3) angiography with a view to performing endovascular occlusion should be undertaken promptly; and 4) endovascular occlusion of the pseudoaneurysm is a viable treatment option.- - - - - - - - - - ranking = 10948.874720983keywords = upper respiratory tract infection, respiratory tract infection, upper respiratory tract, respiratory tract, tract infection, tract, upper (Clic here for more details about this article) |
6/43. Dental guards: helpful or hazards?--a case report.Dental guards are an airway adjunct recommended for patients at risk for dental injury during airway instrumentation; however, reportedly only 2% of anesthesiologists use dental guards during intubation. In this case report, a 64-year-old patient was admitted for a right retromastoid craniectomy with microvascular decompression of the fifth cranial nerve. The patient had crowns on all her maxillary teeth. The anesthesia team, which consisted of a student anesthetist, Certified Registered Nurse Anesthetist, and anesthesiologist, planned to prevent dental damage through the use of a dental guard (Bay Medical, Clearwater, Fla). Prior to intubation a dental guard was inserted on the upper teeth. Induction, intubation, and surgery were uneventful, but in the recovery area the patient complained of a sore throat. After transfer to the intensive care unit, the patient continued to complain of secretions and sore throat and was noted to have hoarseness. When a Yankauer suction catheter was inserted, the dental guard was discovered in the patient's mouth. Apparently during the busy sequence of events following intubation, the dental guard was overlooked and was displaced into the posterior oropharynx. Recommendations for the proper use of dental guards are needed to avoid complications; however, there is a scarcity of information available in the conventional anesthesia literature regarding this intubation adjunct. We recommend careful documentation, clear communication with all team members, and attention to avoid displacement during subsequent airway manipulation.- - - - - - - - - - ranking = 0.34337567660129keywords = upper (Clic here for more details about this article) |
7/43. Reversible cardio-pulmonary changes due to adeno-tonsilar hypertrophy.Adeno-tonsillar hypertrophy, with signs of upper airway obstruction is a common presentation in ENT clinics. Recently it is identified as a major cause of sleep apnea syndrome. Several isolated case reports of pulmonary hypertension and corpulmonale appeared in the literature. The authors report two such children aged less than 2 years with cardio-pulmonary changes occurring secondary to chronic adeno-tonsillar hypertrophy that were successfully treated with the surgical removal.- - - - - - - - - - ranking = 0.34337567660129keywords = upper (Clic here for more details about this article) |
8/43. Lemierre's syndrome.We describe a 32-year-old woman who had temperatures increasing over 7 days from 100.7 degrees F to 104.0 degrees F. She had an upper respiratory infection and swelling of the left side of the neck. She was diagnosed with Lemierre's syndrome.- - - - - - - - - - ranking = 0.34337567660129keywords = upper (Clic here for more details about this article) |
9/43. mycoplasma pneumoniae non-pulmonary infection presenting with pharyngitis, polyarthritis and localized exanthem.We report a case of pharyngitis, polyarthritis and localized exanthem in acute mycoplasma pneumoniae infection not involving the lower respiratory tract. diagnosis was made by means of a particle agglutination test and IgM/IgG indirect immunofluorescence assay. This case describes a clinical complex never reported before and suggests the need for a high index of suspicion in cases of atypical presentation of M. pneumoniae infection.- - - - - - - - - - ranking = 337.50862742054keywords = respiratory tract, tract (Clic here for more details about this article) |
10/43. Bilateral Lemierre's syndrome: a case report and literature review.Lemierre's syndrome is characterized by thrombosis of the internal jugular vein that develops following an oropharyngeal infection. sepsis and septic metastases frequently ensue and affect the lungs, the musculoskeletal system, and occasionally the liver. Most cases are caused by infection with fusobacterium necrophorum. This infection responds to antibiotic therapy with beta-lactamase-resistant compounds that exert good anaerobic coverage. Anticoagulation and surgical intervention can be helpful in advanced cases. Fewer than 160 cases of classic Lemierre's syndrome have been described; approximately one-third of these reported cases have occurred since 1988. We describe a new case of Lemierre's syndrome that occurred in an otherwise healthy 27-year-old man. thrombosis of both internal jugular veins extended through the subclavian system and into both upper extremities. The patient was treated with intravenous antibiotics and heparin during 14 days of hospitalization. He was discharged on oral clindamycin and warfarin sodium, and after 6 months he was able to return to full activity. To our knowledge, this is the first reported case of Lemierre's syndrome in which internal jugular vein thrombosis occurred bilaterally. By reporting this previously undescribed manifestation of Lemierre's syndrome, we hope to increase practitioner awareness of this disease entity.- - - - - - - - - - ranking = 0.34337567660129keywords = upper (Clic here for more details about this article) |
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