传染性单核细胞增多症的异常临床过程:并发双侧囊周脓肿

Yuji Okazaki, Kenichiro Kashiwa, Toshihisa Ichiba
{"title":"传染性单核细胞增多症的异常临床过程:并发双侧囊周脓肿","authors":"Yuji Okazaki,&nbsp;Kenichiro Kashiwa,&nbsp;Toshihisa Ichiba","doi":"10.1016/j.jemrpt.2023.100052","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Infectious mononucleosis (IM) caused by Epstein-Barr virus typically presents with fever, pharyngitis, and lymphadenopathy, and most patients recover within a few weeks. However, bilateral peritonsillar abscess is a rare but serious complication of IM that can lead to airway compromise and descending mediastinitis. Due to its rarity and similarity in clinical presentation of IM, it may be challenging to diagnose bilateral peritonsillar abscess during the course of IM.</p></div><div><h3>Case report</h3><p>A 21-year-old healthy male who initially presented with fever, sore throat, and abdominal discomfort for ten days was diagnosed with IM based on clinical and laboratory findings. Despite initial treatment, the patient returned to the emergency department three times within one week due to persistent symptoms, and on the third visit, he had difficulty opening his mouth and had worsening odynophagia. Contrast-enhanced computed tomography revealed bilateral peritonsillar abscess, and an emergent incision of the right tonsil was performed. Bacterial culture revealed multiple oral organisms. He was diagnosed with bilateral peritonsillar abscess associated with IM and was discharged without complications.</p></div><div><h3>Why should an emergency physician be aware of this?</h3><p>This case highlights two important clinical issues: the potential for patients with IM to develop bilateral peritonsillar abscess and the significance of trismus and exacerbation of odynophagia as a clue for identifying this complication. The rarity of this complication may result in delayed diagnosis and treatment, leading to serious complications. Prompt diagnosis and treatment are crucial for preventing potentially life-threatening consequences.</p></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"2 4","pages":"Article 100052"},"PeriodicalIF":0.0000,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773232023000482/pdfft?md5=a827fa3d9fbee4a6eabcca24e5b7126f&pid=1-s2.0-S2773232023000482-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Unusual clinical course of infectious mononucleosis: Complicating bilateral peritonsillar abscess\",\"authors\":\"Yuji Okazaki,&nbsp;Kenichiro Kashiwa,&nbsp;Toshihisa Ichiba\",\"doi\":\"10.1016/j.jemrpt.2023.100052\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Infectious mononucleosis (IM) caused by Epstein-Barr virus typically presents with fever, pharyngitis, and lymphadenopathy, and most patients recover within a few weeks. However, bilateral peritonsillar abscess is a rare but serious complication of IM that can lead to airway compromise and descending mediastinitis. Due to its rarity and similarity in clinical presentation of IM, it may be challenging to diagnose bilateral peritonsillar abscess during the course of IM.</p></div><div><h3>Case report</h3><p>A 21-year-old healthy male who initially presented with fever, sore throat, and abdominal discomfort for ten days was diagnosed with IM based on clinical and laboratory findings. Despite initial treatment, the patient returned to the emergency department three times within one week due to persistent symptoms, and on the third visit, he had difficulty opening his mouth and had worsening odynophagia. Contrast-enhanced computed tomography revealed bilateral peritonsillar abscess, and an emergent incision of the right tonsil was performed. Bacterial culture revealed multiple oral organisms. He was diagnosed with bilateral peritonsillar abscess associated with IM and was discharged without complications.</p></div><div><h3>Why should an emergency physician be aware of this?</h3><p>This case highlights two important clinical issues: the potential for patients with IM to develop bilateral peritonsillar abscess and the significance of trismus and exacerbation of odynophagia as a clue for identifying this complication. The rarity of this complication may result in delayed diagnosis and treatment, leading to serious complications. Prompt diagnosis and treatment are crucial for preventing potentially life-threatening consequences.</p></div>\",\"PeriodicalId\":73546,\"journal\":{\"name\":\"JEM reports\",\"volume\":\"2 4\",\"pages\":\"Article 100052\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-11-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2773232023000482/pdfft?md5=a827fa3d9fbee4a6eabcca24e5b7126f&pid=1-s2.0-S2773232023000482-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JEM reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2773232023000482\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JEM reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2773232023000482","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:由eb病毒引起的传染性单核细胞增多症(IM)通常表现为发热、咽炎和淋巴结病变,大多数患者在几周内康复。然而,双侧腹膜周围脓肿是一种罕见但严重的并发症,可导致气道损害和降纵隔炎。由于IM的罕见性和临床表现的相似性,在IM过程中诊断双侧腹膜周围脓肿可能具有挑战性。病例报告一名21岁健康男性,最初表现为发烧、喉咙痛和腹部不适10天,根据临床和实验室结果诊断为IM。尽管进行了初步治疗,但由于症状持续,患者在一周内三次返回急诊科,第三次就诊时,他张嘴困难,食道恶化。对比增强计算机断层扫描显示双侧扁桃体周围脓肿,并在右侧扁桃体进行紧急切口。细菌培养显示多种口腔微生物。他被诊断为与IM相关的双侧腹膜周围脓肿,并无并发症出院。急诊医生为什么要意识到这一点?本病例强调了两个重要的临床问题:IM患者发展为双侧腹膜周围脓肿的可能性,以及咬牙和吞咽加剧作为识别这种并发症的线索的重要性。这种并发症的罕见性可能导致诊断和治疗延迟,从而导致严重的并发症。及时诊断和治疗对于预防可能危及生命的后果至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Unusual clinical course of infectious mononucleosis: Complicating bilateral peritonsillar abscess

Background

Infectious mononucleosis (IM) caused by Epstein-Barr virus typically presents with fever, pharyngitis, and lymphadenopathy, and most patients recover within a few weeks. However, bilateral peritonsillar abscess is a rare but serious complication of IM that can lead to airway compromise and descending mediastinitis. Due to its rarity and similarity in clinical presentation of IM, it may be challenging to diagnose bilateral peritonsillar abscess during the course of IM.

Case report

A 21-year-old healthy male who initially presented with fever, sore throat, and abdominal discomfort for ten days was diagnosed with IM based on clinical and laboratory findings. Despite initial treatment, the patient returned to the emergency department three times within one week due to persistent symptoms, and on the third visit, he had difficulty opening his mouth and had worsening odynophagia. Contrast-enhanced computed tomography revealed bilateral peritonsillar abscess, and an emergent incision of the right tonsil was performed. Bacterial culture revealed multiple oral organisms. He was diagnosed with bilateral peritonsillar abscess associated with IM and was discharged without complications.

Why should an emergency physician be aware of this?

This case highlights two important clinical issues: the potential for patients with IM to develop bilateral peritonsillar abscess and the significance of trismus and exacerbation of odynophagia as a clue for identifying this complication. The rarity of this complication may result in delayed diagnosis and treatment, leading to serious complications. Prompt diagnosis and treatment are crucial for preventing potentially life-threatening consequences.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
JEM reports
JEM reports Emergency Medicine
自引率
0.00%
发文量
0
审稿时长
54 days
期刊最新文献
A rare case of yellow nail syndrome in the emergency room setting: A case report Spontaneous perinephric hematoma in an emergency department patient with flank pain: A case report Symptomatic complete heart block: A rare complication of anterior myocardial infarction in a young, fit male: A case report Case of monocular visual impairment Upper gastrointestinal bleeding: A rare presenting sign of pediatric hypothyroidism
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1