Left supraglottic collection with airway compromise

Case contributed by Steve Lau
Diagnosis certain

Presentation

Patient presented to ED with left parapharyngeal swelling and pain.

Patient Data

Age: 50 years
Gender: Female

CT neck shows a left paraglottic rim enhancing low density collection with epicenter at level of hyoid bone. The collection extends cephalad to level of the left faucal tonsil and extends inferiorly to the lamina of the left thyroid cartilage. 

There is extensive surrounding soft tissue edema with effacement of left piriform sinus and laryngo-pharynx displaced to the right with airway narrowing greatest at infrahyoid level.

Case Discussion

Patient's admission bloods show a raised WCC of 11.5. US-guided drainage of the collection was performed which cultured mixed anaerobes confirming an abscess.

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