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Atypical laryngeal dyspnoea with life-threatening obstruction: a case report
Aurélia Bachard1, Dorian Culié2, Agathe Villarmé2
1Centre Antoine Lacassagne, Institut Universitaire de La Face Et du Cou, 33 Avenue de Valombrose, 06189, Nice, France. bachard.a@chu-nice.fr.
Introduction:
Vertebral spondylodiscitis is a rare condition at the level of the cervical spine that can be deadly because of its potential complications. We present a rare case of acute laryngeal dyspnoea resulting from a cervical spine spondylodiscitis (CSS) with an underlying oesophageal fistula.
Case Report:
A 70 year-old-man presented with swallowing disorders, dysphonia and laryngeal dyspnoea one day after a revision surgery for abdominal bowel evisceration. The MRI showed a multilevel spondylodiscitis extending from C4 to C7, associated with epiduritis and an anterior epidural abscess causing spinal cord compression. The treatment included temporary tracheotomy, the wearing of a cervical collar, intravenous broad-spectrum antibiotics during 6 weeks and the interruption of food oral intake. The patient showed a good clinical improvement.
Conclusion:
Special attention should be given to a fever or neck pain in patients with risk factors of CSS, such as history of head and neck cancer treated with radiotherapy. An urgent treatment is required to avoid complications such as compression of the recurrent laryngeal nerves, either a conservative one with antibiotics or a surgical one.
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