Deep cervical abscess following transesophageal echocardiography: A case report

Abstract

Several etiological factors contribute to deep neck abscess formation. We report a case of a deep neck abscess that occurred after transesophageal cardiac ultrasonography, together with a literature review. A 73-year-old man presented with a sore throat. The throat discomfort persisted, following transesophageal cardiac ultrasonography performed in late February 20XX, 3 days prior to his visit. The patient presented to our department for exacerbation of sore throat and onset of dyspnea. Physical examination showed evidence of poor dietary intake, neck erythema and edema, difficulty in neck extension, and a muffled voice. Laryngeal endoscopy revealed erythema and edema, the tendency to airway stenosis, and sputum and pus retention throughout the circumference of the laryngopharyngeal area. Computed tomography of the cervicothorax revealed a low-density area predominantly in the right visceral space with air on the right. Blood test results revealed significantly elevated inflammatory biomarkers. The patient was diagnosed with a deep neck abscess and airway stenosis. We performed emergency tracheostomy and abscess drainage. Postoperative fistulography and upper gastrointestinal endoscopy revealed no laryngopharyngeal and/or esophageal perforations. The patient was discharged on day 36 of hospital admission with a tendency towards reduction of the tracheal foramina. Patients with serious deep neck abscesses warrant prompt treatment after confirmation of the history. This patient developed significant complications, despite careful evaluation and monitoring after transesophageal cardiac ultrasonography. Patients who develop neck pain, dysphagia, fever, and/or dyspnea should seek prompt medical attention at an otolaryngology service.