Safuraa, S., Putra, P., Abu Bakar, S., Hashim, D., Nasseri, Z. (2019). A rare case of tuberculous abscess causing airway obstruction in a paediatric patient in South-East Asia. Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 20(2), 99-103. doi: 10.21608/ejentas.2019.4118.1022
Sharifah Intan Safuraa; Primuharsa Putra; Saraiza Abu Bakar; Dina Hashim; Zara Nasseri. "A rare case of tuberculous abscess causing airway obstruction in a paediatric patient in South-East Asia". Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 20, 2, 2019, 99-103. doi: 10.21608/ejentas.2019.4118.1022
Safuraa, S., Putra, P., Abu Bakar, S., Hashim, D., Nasseri, Z. (2019). 'A rare case of tuberculous abscess causing airway obstruction in a paediatric patient in South-East Asia', Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 20(2), pp. 99-103. doi: 10.21608/ejentas.2019.4118.1022
Safuraa, S., Putra, P., Abu Bakar, S., Hashim, D., Nasseri, Z. A rare case of tuberculous abscess causing airway obstruction in a paediatric patient in South-East Asia. Egyptian Journal of Ear, Nose, Throat and Allied Sciences, 2019; 20(2): 99-103. doi: 10.21608/ejentas.2019.4118.1022
A rare case of tuberculous abscess causing airway obstruction in a paediatric patient in South-East Asia
1Department of Otorhinolaryngology- Head & Neck Surgery, National University of Malaysia Medical Centre, Kuala Lumpur
2Ear, Nose, Throat-Head & Neck Consultant Clinic, KPJ Seremban Specialist Hospital/KPJ Healthcare University College, Negeri Sembilan
3Department of Otorhinolaryngology-Head & Neck Surgery, Serdang Hospital, Serdang, Selangor, Malaysia
4Department of Otorhinolaryngology, Head and Neck Surgery Faculty of Medicine University Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia
Abstract
A 6-year old girl, presented with symptoms of obstructive sleep apnoea. She was referred to our centre when she developed obstructive symptoms such as stridor and dysphagia a month later. She was found to have a right neck swelling with a posterior pharyngeal wall mass, which caused upper airway obstruction. A computerized-tomography scan of her neck showed a very narrowed upper airway with a retropharyngeal abscess without prevertebral or vertebral involvement. She had a challenging intubation and underwent an emergency intraoral incision and drainage. Pus that was drained revealed acid fast bacilli and histopathological examination showed necrotizing granulomatous inflammation, in favour of a tuberculous abscess. Post operatively, her symptoms resolved and her intraoral wound healed. She completed anti-tuberculous treatment and has remained well at 6 months follow up. Our case illustrates how a cold retropharyngeal abscess can masquerade as obstructive sleep apnoea, with a compromised airway as it increases in size.