Cases reported "Pharyngitis"

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1/13. 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.
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ranking = 1
keywords = airway obstruction, airway, obstruction
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2/13. 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.
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ranking = 0.099266137270336
keywords = airway
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3/13. 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.
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ranking = 0.5
keywords = airway obstruction, airway, obstruction
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4/13. Acute epiglottitis in adults. Presentation of cases.

    Acute epiglottitis is a dangerous disease which is not often seen in adults. early diagnosis and medical attention is required. Relief of airway obstruction by intubation or tracheostomy is necessary in most cases. ampicillin plus chloramphenicol or only cefotaxime is administered, pending a report on sensitivities. 3 cases of acute epiglottitis in adults are presented. The management is discussed in view to avoid this disease's possible fatal outcome.
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ranking = 0.5
keywords = airway obstruction, airway, obstruction
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5/13. adult epiglottitis.

    epiglottitis is supraglottic inflammation of the oropharynx caused by infective, thermal, or caustic insult. Rapid swelling of the epiglottis results in airway obstruction and asphyxia. Widespread use of HiB vaccination in children has resulted in a reduction in childhood cases of epiglottitis. The majority of adults have not received vaccination, and remain susceptible. Peak incidence is in the 35- to 39-year-old age group with an annual incidence of 0.97-1.8/100,000, approximately 2.5 times the incidence in children (Sack and Brock, 2002; Carey, 1996; Fontanarosa et al., 1989). We present three cases of adult epiglottitis presenting to a District Hospital Accident and Emergency (A&E) department in Yorkshire over a six-month period.
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ranking = 0.5
keywords = airway obstruction, airway, obstruction
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6/13. Streptococcal pharyngitis and epiglottitis in a newborn infant.

    We describe a newborn infant with streptococcus sanguis septicaemia and concomitant upper airway obstruction due to epiglottitis and pharyngitis. This rare infection of the supraglottic region was treated with endotracheal intubation and antibiotics. Full recovery occurred within 4 days.
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ranking = 0.5
keywords = airway obstruction, airway, obstruction
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7/13. infection of the neck spaces: a present day complication.

    Although advances in antibiotic therapy have made adult neck space infections an uncommon event, it is essential to bear them in mind when treating oro-dental and oro-pharyngeal sepsis, as they can often progress with life threatening sequelae. Three cases of neck space infection as a consequence of dental infection, pharyngitis and peritonsillar abscess are presented. The management of a potentially compromised airway is of paramount importance in the immediate treatment of neck space sepsis.
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ranking = 0.033088712423445
keywords = airway
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8/13. life-threatening pharyngitis caused by herpes simplex virus, type 2.

    A 21-year-old man who had pharyngitis needed hospitalization for observation of airway patency and for parenteral fluid therapy. infection with herpes simplex virus, type 2 (HSV-2), was diagnosed on the basis of the finding of significantly increased IgM indirect hemagglutination antibody titers. The pharyngitis appeared to have been contracted by heterosexual orogenital contact (cunnilingus). The results of this case study indicate that HSV-2 infection should be considered in the differential diagnosis in cases of severe pharyngitis in sexually active patients.
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ranking = 0.033088712423445
keywords = airway
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9/13. Obstructive epiglottitis in adults.

    Acute epiglottitis, considered primarily a disease of infancy and early childhood, is seen rarely in adulthood but may be increasing in incidence. Although it may appear more slowly in adults, it is imperative to establish a rapid diagnosis and promptly assure care for this life-threatening disease. epiglottitis may cause total obstruction of the upper airway, and it often falls to the primary care physician to discriminate this disease from the many self-limiting infections of the upper airway. The diagnosis should be considered if dysphagia and sore throat are not accompanied by hoarseness. Management of the airway is the first priority, but intravenous antibiotic use is justified.
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ranking = 0.10932211903007
keywords = airway, obstruction
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10/13. The otolaryngologic presentation of botulism.

    botulism, although an uncommon disease, may nonetheless present to the otolaryngologist. The clinical signs of a severely erythematous, parched tongue, oropharynx, hypopharynx and larynx, especially when associated with bilateral cranial nerve deficits, should arouse suspicion of this disorder. Once the presumptive diagnosis of botulism is made, the otolaryngologist should expeditiously act to ensure appropriate airway control, as respiratory collapse may be imminent.
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ranking = 0.033088712423445
keywords = airway
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