Majd Werda, Rania Laajailia, Ayoub Smaoui, Malek Mnejja, Ilheme Charfeddine
{"title":"一例罕见的插管后环状软骨脓肿的诊断和治疗方法。","authors":"Majd Werda, Rania Laajailia, Ayoub Smaoui, Malek Mnejja, Ilheme Charfeddine","doi":"10.1177/01455613251341147","DOIUrl":null,"url":null,"abstract":"<p><p>We report a life-threatening post-intubation cricoid abscess in a 29-year-old diabetic male, highlighting the challenges of airway compromise management. Following 7 days of mechanical ventilation for severe pneumonia, the patient developed acute dysphonia, inspiratory stridor, and progressive dyspnea culminating in resting respiratory distress (ambulation <10 m). Bedside laryngoscopy revealed a 70% obstructing subglottic mass with inflammatory changes. Contrast computed tomography identified a 23 mm rim-enhancing cricoid abscess causing critical airway stenosis. Immediate tracheostomy secured the airway, with subsequent operative drainage yielding <i>Streptococcus</i> species resistant to first-line antibiotics. Targeted IV ceftazidime and oral ciprofloxacin achieved resolution, permitting decannulation at 21 days. This case underscores 3 critical lessons: (1) the heightened infection risk in diabetics post-intubation, (2) the value of rapid endoscopic airway assessment in post-extubation dyspnea, and (3) the necessity of culture-directed therapy in deep neck space infections. Unlike typical laryngotracheal complications (eg, granulomas or stenosis), abscess formation at the cricoid represents a rare but potentially fatal etiology of post-intubation airway obstruction requiring multidisciplinary intervention. Early imaging and surgical drainage proved pivotal in preventing catastrophic outcomes in this immunocompromised host.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251341147"},"PeriodicalIF":0.0000,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Rare Case of Post-Intubation Cricoid Cartilage Abscess: Diagnosis and Therapeutic Approach.\",\"authors\":\"Majd Werda, Rania Laajailia, Ayoub Smaoui, Malek Mnejja, Ilheme Charfeddine\",\"doi\":\"10.1177/01455613251341147\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>We report a life-threatening post-intubation cricoid abscess in a 29-year-old diabetic male, highlighting the challenges of airway compromise management. Following 7 days of mechanical ventilation for severe pneumonia, the patient developed acute dysphonia, inspiratory stridor, and progressive dyspnea culminating in resting respiratory distress (ambulation <10 m). Bedside laryngoscopy revealed a 70% obstructing subglottic mass with inflammatory changes. Contrast computed tomography identified a 23 mm rim-enhancing cricoid abscess causing critical airway stenosis. Immediate tracheostomy secured the airway, with subsequent operative drainage yielding <i>Streptococcus</i> species resistant to first-line antibiotics. Targeted IV ceftazidime and oral ciprofloxacin achieved resolution, permitting decannulation at 21 days. This case underscores 3 critical lessons: (1) the heightened infection risk in diabetics post-intubation, (2) the value of rapid endoscopic airway assessment in post-extubation dyspnea, and (3) the necessity of culture-directed therapy in deep neck space infections. Unlike typical laryngotracheal complications (eg, granulomas or stenosis), abscess formation at the cricoid represents a rare but potentially fatal etiology of post-intubation airway obstruction requiring multidisciplinary intervention. Early imaging and surgical drainage proved pivotal in preventing catastrophic outcomes in this immunocompromised host.</p>\",\"PeriodicalId\":93984,\"journal\":{\"name\":\"Ear, nose, & throat journal\",\"volume\":\" \",\"pages\":\"1455613251341147\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-05-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ear, nose, & throat journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/01455613251341147\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ear, nose, & throat journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/01455613251341147","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
A Rare Case of Post-Intubation Cricoid Cartilage Abscess: Diagnosis and Therapeutic Approach.
We report a life-threatening post-intubation cricoid abscess in a 29-year-old diabetic male, highlighting the challenges of airway compromise management. Following 7 days of mechanical ventilation for severe pneumonia, the patient developed acute dysphonia, inspiratory stridor, and progressive dyspnea culminating in resting respiratory distress (ambulation <10 m). Bedside laryngoscopy revealed a 70% obstructing subglottic mass with inflammatory changes. Contrast computed tomography identified a 23 mm rim-enhancing cricoid abscess causing critical airway stenosis. Immediate tracheostomy secured the airway, with subsequent operative drainage yielding Streptococcus species resistant to first-line antibiotics. Targeted IV ceftazidime and oral ciprofloxacin achieved resolution, permitting decannulation at 21 days. This case underscores 3 critical lessons: (1) the heightened infection risk in diabetics post-intubation, (2) the value of rapid endoscopic airway assessment in post-extubation dyspnea, and (3) the necessity of culture-directed therapy in deep neck space infections. Unlike typical laryngotracheal complications (eg, granulomas or stenosis), abscess formation at the cricoid represents a rare but potentially fatal etiology of post-intubation airway obstruction requiring multidisciplinary intervention. Early imaging and surgical drainage proved pivotal in preventing catastrophic outcomes in this immunocompromised host.