Severe parapharyngeal abscess that developed significant complications: management during the COVID-19 pandemic. Issue 12 (22nd December 2020)

• Record Type: Journal Article
• Authors: Ajeigbe, Teslimat; Ria, Basmal; Wates, Emma; Mattine, Samuel
• Is Part Of: BMJ case reports. Volume 13:Issue 12(2020)
• Publication Date: 2020-12-22
• Subjects: ear -- nose and throat/otolaryngology -- anaesthesia -- cardiothoracic surgery -- oral and maxillofacial surgery; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2020-236449
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A 50-year-old Caucasian man presented to the emergency department during the early stages of the COVID-19 pandemic with a rapidly progressive facial swelling, fever, malaise and myalgia. The patient had recently travelled to a COVID-19-prevalent European country and was therefore treated as COVID-19 suspect. The day before, the patient sustained a burn to his left forearm after falling unconscious next to a radiator. A CT neck and thorax showed a parapharyngeal abscess, which was surgically drained, and the patient was discharged following an intensive care admission. He then developed mediastinitis 3 weeks post-discharge which required readmission and transfer to a cardiothoracic unit for surgical drainage. This report discusses the evolution of a deep neck space infection into a mediastinitis, a rare and life-threatening complication, despite early surgical drainage. This report also highlights the difficulties faced with managing patients during the COVID-19 pandemic.