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Citrobacter freundii causing pharyngitis and secondary retropharyngeal abscess with intrathoracic extension to the diaphragm: minimally invasive management of a rare case

Published online by Cambridge University Press:  23 March 2010

A Trinidade ,
V Sekhawat ,
Z Andreou ,
J Meldrum ,
S Kamat  and
J Panesar
A Trinidade*
Affiliation:
Department of Otolaryngology, Luton and Dunstable Hospital, Lewsey Rd, Luton LU4 0DZ
V Sekhawat
Affiliation:
Department of Otolaryngology, Luton and Dunstable Hospital, Lewsey Rd, Luton LU4 0DZ
Z Andreou
Affiliation:
Department of Otolaryngology, Luton and Dunstable Hospital, Lewsey Rd, Luton LU4 0DZ
J Meldrum
Affiliation:
Department of Otolaryngology, Luton and Dunstable Hospital, Lewsey Rd, Luton LU4 0DZ
S Kamat
Affiliation:
Department of Otolaryngology, Luton and Dunstable Hospital, Lewsey Rd, Luton LU4 0DZ
J Panesar
Affiliation:
Department of Otolaryngology, Luton and Dunstable Hospital, Lewsey Rd, Luton LU4 0DZ
*
Address for correspondence: Mr Aaron Trinidade, ENT Department, Luton and Dunstable Hospital, Lewsey Road, Luton LU4 0DZ, UK. E-mail: aarontrinidade@gmail.com
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Abstract

Introduction:

Citrobacter freundii is a rare but potentially aggressive cause of pharyngitis which may progress to retropharyngeal abscess with diaphragmatic extension.

Objective:

To raise awareness of: (1) citrobacter as a potential cause of head and neck infection, including retropharyngeal abscess; (2) a novel surgical approach to draining such an abscess; and (3) citrobacter's particular biological properties which may affect the clinical course.

Method:

Case report.

Results:

The abscess was drained via a minimally invasive posterior pharyngeal wall incision and placement of a suction catheter into the mediastinum through this incision. Residual intrathoracic collections were drained by the cardiothoracic team via percutaneous aspiration. The patient made a full recovery.

Conclusion:

Early recognition of citrobacter head and neck infections, an awareness of the peculiarities of the clinical course of such infections, and timely surgical intervention can prevent catastrophic outcomes. A minimally invasive approach to mediastinal collections can be considered as a viable alternative to open thoracotomy, which carries a high morbidity rate.

Keywords

Citrobacter FreundiiRetropharyngeal Abscess

Information

Type
Online Only Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 5 , May 2010 , e4
Copyright
Copyright © JLO (1984) Limited 2010

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