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Acinetobacter Prevertebral Abscess: Presenting as Dysphagia in a Diabetic Patient
R Manmathan1, T Kumanan2, J A Pradeepan2
1University Medical Unit, Teaching Hospital Jaffna, Jaffna, Sri Lanka.
Abstract:
Acinetobacter species frequently causes nosocomial infection, particularly in patients receiving invasive ventilation at intensive care units for a prolonged period. Odynophagia is a rare, initial clinical manifestation of prevertebral abscess which subsequently develops when the abscess extends into the retropharyngeal space causing a midline bulge of the posterior pharyngeal wall. Here, we present and discuss a patient with uncontrolled diabetic mellitus who presented with severe odynophagia and dysphagia. He was diagnosed to have prevertebral abscess caused by a rarely reported bacteria, Acinetobacter baumannii.
Insights
Acinetobacter baumannii rarely causes prevertebral abscesses, a serious infection. This case highlights severe odynophagia as an initial symptom in a diabetic patient, emphasizing unusual presentations of nosocomial infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Critical Care Medicine
Background:
- Acinetobacter species are common causes of hospital-acquired infections, especially in intensive care units.
- Prevertebral abscesses can manifest with odynophagia (painful swallowing) due to retropharyngeal space involvement.
- Uncontrolled diabetes mellitus is a risk factor for severe infections.
Observation:
- A patient with uncontrolled diabetes presented with severe odynophagia and dysphagia.
- Clinical examination revealed a posterior pharyngeal wall bulge, suggestive of a developing abscess.
Findings:
- The patient was diagnosed with a prevertebral abscess.
- Cultures identified the causative agent as Acinetobacter baumannii, a rare cause of this condition.
Implications:
- This case underscores the importance of considering rare bacterial pathogens in complex infections.
- Acinetobacter baumannii should be considered in the differential diagnosis of prevertebral abscesses, particularly in immunocompromised patients.
- Early recognition of unusual symptoms like severe odynophagia is crucial for timely diagnosis and treatment of prevertebral abscesses.
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