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Life-threating complication of parapharyngeal abscess and mediastinitis in a 10-year-old otherwise healthy girl following elective tonsillectomy – first reported paediatric case

Published online by Cambridge University Press:  21 March 2019

C C Holm-Hansen ,
E Thisted  and
M Kaltoft
C C Holm-Hansen*
Affiliation:
Department of Paediatrics, Zealand University Hospital, Roskilde, Denmark
E Thisted
Affiliation:
Department of Paediatrics, Zealand University Hospital, Roskilde, Denmark
M Kaltoft
Affiliation:
Department of Oto-rhino-laryngology – Head and Neck Surgery, Copenhagen University Hospital, Denmark
*
Author for correspondence: Dr Charlotte Carina Holm-Hansen, Juliane Marie Centre, 2nd Floor, Copenhagen University Hospital, Tagensvej 22, Copenhagen, Denmark E-mail: Charlotte.carina.holm-hansen@regionh.dk
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Abstract

Background

Parapharyngeal abscess and mediastinitis are rare but very severe post-operative complications following an elective tonsillectomy. Parapharyngeal abscess as a complication to tonsilectomy is very seldom described in the literature and no cases in the paediatric population have been described.

Case report

This paper presents, to our knowledge, the first case of life-threatening parapharyngeal abscess and mediastinitis following elective adenotonsillectomy in an otherwise healthy, fully vaccinated 10-year-old girl.

Conclusion

Diagnosing parapharyngeal abscess and mediastinitis can be challenging, but should be suspected and ruled out in cases of post-operative odynophagia, fever, and/or neck swelling and thoracic pain. Diagnosis is made based on magnetic resonance imaging and computed tomography findings. Prompt broad-spectrum intravenous antibiotic treatment and surgical drainage should be initiated. Other severe complications such as meningitis should also be considered.

Keywords

Elective Surgical ProcedureTonsillectomyPostoperative ComplicationsRetropharyngeal AbscessMediastinitisInfectionPediatrics
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 2 , February 2019 , pp. 161 - 163
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr C C Holm-Hansen takes responsibility for the integrity of the content of the paper

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