Aut@r o Autores: A. Cuelliga-Gonzalez, F. Barqueros-Escuer, G. LitranLopez, J. Felices-Farias, A. Navarro-Baño, M. Ato-Gonzalez, .
A 20-years-old patient came to our service due to persistence of high-grade fever, significant neck discomfort, including odynophagia, dysphagia and trismus, with the subjective impression of laterocervical bulges growth after 2 weeks of tonsillitis. The patient did not present a medical history of interest.
First, we performed an ultrasound, observing a heterogeneous echogenicity mass, poorly defined, located in the left thyroid lobe with deep extension underlying the sternocleidomastoid, so we decided to perform a CT scan. Secondary tyroid abscess resulting from acute tonsillitis is an unusual type of neck infection. If, as in our case, the abscess involve the retropharyngeal space is a potentially life-threatening that requires prompt diagnosis and aggressive therapy. CT is fast at evaluating the neck, which is an important factor when imaging patients with potential narrowing of the airway. Scans should be obtained with contrast to allow differentiation of fluid collections from phlegmonous thickening. Imaging findings: multitabicated collection dependent on the left thyroid lobe, which heterogeneous enhancement after intravenous contrast with spread to the submandibular, suprahyoid, left parapharyngeal and retropharyngeal space,partially collapsing the ipsilateral jugular vein. The mass causes a narrowing of the airway. All these findings are characteristic of cervical abscess with retropharyngeal extension. The patient was operated urgently after the described findings.
- Secondary tyroid abscess resulting from acute tonsillitis is an unusual type of neck infection. - CT is excellent for neck evaluation urgently, since early diagnosis is crucial to avoid life-threatening complications (mainly airway occlusion).
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