A 15-Month-Old Boy With Respiratory Distress and Parapharyngeal Abscess: A Case Report

  • Behdad Gharib Department of Pediatric Intensive Care, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Masoud Mohammadpour Department of Pediatric Intensive Care, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Meisam Sharifzadeh Department of Pediatric Intensive Care, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Fatemeh Mirashrafi Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Bahareh Yaghmaie Department of Pediatric Intensive Care, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Neda Pak Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Mehrzad Mehdizadeh Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Hamid Eshaghi Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Mojtaba Gorji Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Sara Memarian Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Keywords: Parapharyngeal abscess, Respiratory distress, Mediastinitis, Retropharyngeal abscess

Abstract

Parapharyngeal abscess is a life-threatening disease. Upper respiratory tract infection is the main cause in children. We present a 15-month-old boy admitted to the emergency ward with the chief complaint of difficulty in breathing caused by parapharyngealabscess. His condition deteriorated gradually, and he transferred to the operation theater quickly for abscess drainage and because of the difficulty in orotracheal intubation; a tracheostomy was performed. His respiratory condition deteriorated 2 days after PICU admission, and the medical team noticed an unexplainable respiratory distress. A chest x ray obtained and showed a right side pneumothorax and subcutaneous emphysema around theneck area. The case presented here, had not been diagnosed at the first examination; however, there were enough clinical clues (such as respiratory distress, drooling, torticollis, bulging of theneck, previous viral respiratory infection, possible pharyngeal trauma). The story of this case reminds us the importance of the precise physical exam and history taking which could be life-saving.

Author Biography

Mehrzad Mehdizadeh, Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Assistant Professor of Pediatric infectious Disease

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Published
2017-01-14
How to Cite
1.
Gharib B, Mohammadpour M, Sharifzadeh M, Mirashrafi F, Yaghmaie B, Pak N, Mehdizadeh M, Eshaghi H, Gorji M, Memarian S. A 15-Month-Old Boy With Respiratory Distress and Parapharyngeal Abscess: A Case Report. Acta Med Iran. 54(12):812-816.
Section
Case Report(s)