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Published on: June 28, 2018
Multidisciplinary Team in Severe Infectious Complications Caused by Pharyngeal Foreign Body
Tianyu Wang1, Yin Cheng1, Caiquan Liang1
1Department of Otolaryngology-Head and Neck Surgery, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Background:
Pharyngeal foreign body is not only a common emergency in people's daily life, but also a common simple disease in otorhinolaryngology. However, the disease is easy to be ignored due to its common occurrence, which may lead to a series of serious complications including sepsis and local abscess.
Case Presentation:
In this case, a patient with sepsis, piriform fistula, deep neck abscess, and mediastinal abscess caused by a fishbone was reported. After reviewing the international literature on severe infectious complications caused by foreign bodies in pharynx, the authors emphasize the important role of multidisciplinary team in dealing with complex complications.
Result:
The whole process of patient from onset to recovery was summarized in a timeline. During hospitalization, the value of leukocyte counts and C-reactive protein in routine blood test was record dynamically. The electronic laryngoscopy, neck computed tomography and chest computed tomography were used to judge treatment efficacy. After about 2 months of hospitalization, the patient was recovered without sequelae. No adverse reactions were found during the follow-up.
Conclusion:
The incorrect method of removing foreign body after mis-swallowing may develop serious complications. Therefore, It is important to strengthen medical preaching for general population of correct treatments after foreign body ingestion. In addition, the case reminds clinicians to pay more attention to patients' medical history and details of all medical examinations, which may provide significant clues for making the correct diagnosis and treatment quickly.
Insights
Pharyngeal foreign bodies, often overlooked, can cause severe infections like sepsis and abscesses. Prompt diagnosis and multidisciplinary care are crucial for managing these potentially life-threatening complications.
Area of Science:
- Otorhinolaryngology
- Infectious Diseases
- Emergency Medicine
Background:
- Pharyngeal foreign bodies are common emergencies but frequently underestimated.
- Delayed recognition can lead to severe complications such as sepsis and abscesses.
Observation:
- A case of a patient with sepsis, piriform fistula, deep neck, and mediastinal abscesses secondary to a fishbone foreign body is presented.
- Diagnostic imaging included electronic laryngoscopy, neck CT, and chest CT.
- Leukocyte counts and C-reactive protein were monitored dynamically.
Findings:
- The patient recovered fully within two months without sequelae.
- Multidisciplinary team management was essential for addressing complex infectious complications.
- Correct diagnosis and treatment were facilitated by careful attention to medical history and examination details.
Implications:
- Highlights the critical importance of correct foreign body removal techniques and public education.
- Emphasizes the need for heightened clinical vigilance regarding pharyngeal foreign bodies and their potential complications.
- Underscores the value of a multidisciplinary approach in managing severe infectious sequelae from foreign bodies.
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