A Case of Deep Neck Abscess Following a Folk Remedy for Fish Bone Migration

Abstract

We frequently encounter cases of fish bone migration, but rarely observe severe complications arising from them. Here, we report a case of a deep neck abscess secondary to cervical esophageal perforation that developed after a folk remedy for fish bone migration.

A 69-year-old woman visited our hospital complaining of pharyngeal pain that was persistent since the accidental ingestion of a sea bream bone followed by temporary reduction in the severity of the symptoms after swallowing a whole rice cake. The anterior neck was swollen. A blood test detected an inflammatory reaction, and computed tomography revealed a deep neck abscess with a pattern of gas production.

The patient underwent emergency surgical drainage on the day of the initial examination. Streptococcus milleri, S. mitis, and Prevotella spp., among others, were detected in the pus, indicating a mixed infection. After the surgery, administration of antibiotics and wound cleaning were continued, which resulted in an improvement in her status.

Although the incidence of a deep neck abscess secondary to accidental ingestion of a foreign body is only 0.3%, there is a possibility that severe complications arise from accidentally ingested foreign matter, as shown in the case presented here. We should also recognize that an erroneous folk remedy for accidental ingestion of a foreign object can also cause severe complications.