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Chrisnata V, Sugiarto A, Erniody E, Sethiono A. Sudden life-threatening laryngeal edema in pregnancy: a case report. J Med Case Rep 2023; 17:180. [PMID: 37076895 PMCID: PMC10116716 DOI: 10.1186/s13256-023-03880-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/07/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Severe laryngeal edema during pregnancy is uncommon but can be encountered, particularly in patients with preeclampsia accompanied by other comorbidities. Careful consideration must be given to balance the urgency of securing the airway with the safety of the fetus and the patient's long-term health consequences. CASE PRESENTATION A 37-year-old Indonesian woman was brought to the emergency department at 36 weeks gestation due to severe dyspnea. Her condition worsened a few hours later during intensive care unit admission, with tachypnea, decreased oxygen saturation, and inability to communicate, necessitating intubation. Due to the edematous larynx, we could only use 6.0-sized endotracheal tube. The use of a small-sized endotracheal tube was expected to be short-lived, so she was considered for tracheostomy. Nevertheless, we decided to perform a cesarean section first after lung maturation because it would be safer for the fetus, and laryngeal edema usually improves after delivery. Cesarean section was performed under spinal anesthesia for the safety of the fetus, and 48 hours after delivery, she underwent a leakage test with a positive result, so extubation was performed. Stridor was no longer audible, breathing pattern was within normal limits, and vital signs were stable. The patient and her baby both recovered well with no long-term health consequences. CONCLUSION This case demonstrates that unexpected life-threatening laryngeal edema can occur during pregnancy, in which upper respiratory tract infections may trigger it. The decision between conservative and aggressive immediate airway management should be made with careful consideration of securing the patient's airway, the safety of the fetus, and the patient's long-term health consequences.
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Affiliation(s)
- Vincent Chrisnata
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Ciptomangunkusumo Hospital, Jakarta, Indonesia.
- Department of Anesthesiology and Intensive Care, Husada Hospital, Jakarta, Indonesia.
| | - Adhrie Sugiarto
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Ciptomangunkusumo Hospital, Jakarta, Indonesia
| | - Erniody Erniody
- Department of Anesthesiology and Intensive Care, Husada Hospital, Jakarta, Indonesia
| | - Aldy Sethiono
- Department of Anesthesiology and Intensive Care, Husada Hospital, Jakarta, Indonesia
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Alhedaithy AA, Murad IS, Aldabal N. Acute laryngotracheitis caused by COVID-19: A case report and literature review. Int J Surg Case Rep 2022; 94:107074. [PMID: 35433234 PMCID: PMC9005240 DOI: 10.1016/j.ijscr.2022.107074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/09/2022] [Accepted: 04/09/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Presentation of case Clinical findings and investigations Interventions and outcome Conclusion A 52-year-old woman presented to the ER with a two-day history of shortness of breath and inspiratory stridor. The patient was admitted to the ICU for possible surgical airway. she tested positive for COVID-19 by polymerase chain reaction testing of nasopharyngeal samples. A regimen of ceftriaxone, nebulized racemic epinephrine, and dexamethasone was initiated. The patient’s symptoms started to improve over the next few days. On day 4 of hospitalization, she moved to a level 1 bed, and a week later, she was discharged Early diagnostic testing for SARS-Cov-2 are strongly recommended even when symptoms are not typical of COVID-19
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Affiliation(s)
| | | | - Nada Aldabal
- King Fahad Medical Military Complex, Dhahran, Saudi Arabia.
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Talmor G, Nguyen B, Din-Lovinescu C, Paskhover B, Kaye R. Vocal Fold Immobility Following Vaccination. Ann Otol Rhinol Laryngol 2020; 130:609-613. [PMID: 33063519 DOI: 10.1177/0003489420965633] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Vocal fold immobility (VFI) may severely affect quality of life due to dysphonia and respiratory distress. Many etiologies of this disorder have been evaluated, however the relationship between VFI and vaccination has yet to be explored. The objective of this study was to identify the relationship between VFI and vaccine administration. METHODS The Vaccine Adverse Event Reporting System (VAERS) database was queried for patients exhibiting symptoms of VFI following vaccination. Patient demographics and clinical information including presenting symptoms, time of symptom onset, laterality, outcomes, and adverse events were documented. RESULTS Twenty-two patients were found to have VFI following vaccination. Of those reported, 13 patients were female (59.1%) and 8 were male (36.4%) with an average age of 48.4 years. Vaccinations for influenza, shingles, pneumococcus, and hepatitis B were reported. A majority of these cases were unilateral in nature (73.3%). Mean lag time from vaccination to symptom onset was 6.3 days (range 0-45 days). Five adverse events were reported, with 4 patients requiring intubation and tracheostomy. CONCLUSION Vaccine administration may be associated with VFI and physicians should be cognizant of this potential adverse event. This is a rare complication with less reported cases than other post-vaccination cranial neuropathies. The difficulty in establishing an initial diagnosis and need for specialized evaluation by an otolaryngologist may result in under-reporting of such events. Further research is needed to delineate the exact pathophysiology of this complication and determine whether a causal relationship exists.
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Affiliation(s)
- Guy Talmor
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Brandon Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Corina Din-Lovinescu
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Boris Paskhover
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Rachel Kaye
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
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Oliver CM, Campbell M, Dulan O, Hamilton N, Birchall M. Appearance and management of COVID-19 laryngo-tracheitis: two case reports. F1000Res 2020; 9:310. [PMID: 32724561 PMCID: PMC7364183 DOI: 10.12688/f1000research.23204.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2020] [Indexed: 12/14/2022] Open
Abstract
We present two cases of coronavirus disease 2019 (COVID-19)-related laryngotracheitis in good-prognosis, ventilated patients who had failed extubation. As the pandemic continues to unfold across the globe and better management of those with respiratory failure develops, this may be an increasingly common scenario. Close ENT-intensivist liaison, meticulous team preparation, early consideration of rigid endoscopy and prospective data collection and case sharing are recommended.
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Affiliation(s)
- Charles Matthew Oliver
- Departments of Anaesthesia and Intensive Care Medicine, Royal Free Hampstead NHS Trust Hospital, London, nw3 2qg, UK
- Division of Surgery and Interventional Science, University College London, London, W1W 7TS, UK
- University College London Hospitals NHS Trust, London, NW1 2BU, UK
| | - Marta Campbell
- Departments of Anaesthesia and Intensive Care Medicine, Royal Free Hampstead NHS Trust Hospital, London, nw3 2qg, UK
| | - Oma Dulan
- Departments of Anaesthesia and Intensive Care Medicine, Royal Free Hampstead NHS Trust Hospital, London, nw3 2qg, UK
| | - Nick Hamilton
- University College London Hospitals NHS Trust, London, NW1 2BU, UK
- Ear Institute, University College London, London, WC1X 8EE, UK
- NIHR Biomedical Research Centre, University College London Hospitals, London, UK
| | - Martin Birchall
- University College London Hospitals NHS Trust, London, NW1 2BU, UK
- Ear Institute, University College London, London, WC1X 8EE, UK
- NIHR Biomedical Research Centre, University College London Hospitals, London, UK
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Oliver CM, Campbell M, Dulan O, Hamilton N, Birchall M. Appearance and management of COVID-19 laryngo-tracheitis: two case reports. F1000Res 2020; 9:310. [PMID: 32724561 PMCID: PMC7364183 DOI: 10.12688/f1000research.23204.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/24/2020] [Indexed: 12/23/2023] Open
Abstract
We present two cases of coronavirus disease 2019 (COVID-19)-related laryngotracheitis in good-prognosis, ventilated patients who had failed extubation. As the pandemic continues to unfold across the globe and better management of those with respiratory failure develops, this may be an increasingly common scenario. Close ENT-intensivist liaison, meticulous team preparation, early consideration of rigid endoscopy and prospective data collection and case sharing are recommended.
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Affiliation(s)
- Charles Matthew Oliver
- Departments of Anaesthesia and Intensive Care Medicine, Royal Free Hampstead NHS Trust Hospital, London, nw3 2qg, UK
- Division of Surgery and Interventional Science, University College London, London, W1W 7TS, UK
- University College London Hospitals NHS Trust, London, NW1 2BU, UK
| | - Marta Campbell
- Departments of Anaesthesia and Intensive Care Medicine, Royal Free Hampstead NHS Trust Hospital, London, nw3 2qg, UK
| | - Oma Dulan
- Departments of Anaesthesia and Intensive Care Medicine, Royal Free Hampstead NHS Trust Hospital, London, nw3 2qg, UK
| | - Nick Hamilton
- University College London Hospitals NHS Trust, London, NW1 2BU, UK
- Ear Institute, University College London, London, WC1X 8EE, UK
- NIHR Biomedical Research Centre, University College London Hospitals, London, UK
| | - Martin Birchall
- University College London Hospitals NHS Trust, London, NW1 2BU, UK
- Ear Institute, University College London, London, WC1X 8EE, UK
- NIHR Biomedical Research Centre, University College London Hospitals, London, UK
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Kuroda H, Hase R. Herpes Zoster Laryngitis with Disseminated Cutaneous Lesions. Intern Med 2019; 58:2905-2906. [PMID: 31243199 PMCID: PMC6815882 DOI: 10.2169/internalmedicine.2886-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Hirokazu Kuroda
- Department of Infectious Diseases, Kameda Medical Center, Japan
- Department of Infectious Diseases, Japanese Red Cross Narita Hospital, Japan
| | - Ryota Hase
- Department of Infectious Diseases, Japanese Red Cross Narita Hospital, Japan
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Hagiya H, Yoshida H, Shimizu M, Motooka D, Nakamura S, Iida T, Yamamoto N, Akeda Y, Tomono K. Herpes zoster laryngitis in a patient treated with fingolimod. J Infect Chemother 2016; 22:830-832. [PMID: 27553068 DOI: 10.1016/j.jiac.2016.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/19/2016] [Accepted: 07/21/2016] [Indexed: 02/02/2023]
Abstract
Development of treatment with immunomodulatory agents has improved prognosis of various autoimmune-related diseases. A sphingosin-1-phosphate receptor modulator, or fingolimod, is the first licensed oral drug for relapsing-remitting multiple sclerosis. The agent reduces circulating lymphocytes by trapping T cells in lymph nodes, possibly leading to reactivation of latent viruses. A 41-year-old Japanese woman who had been treated with fingolimod for 2 years presented with unilateral sore throat. Laryngoscopy revealed exudates unilaterally emerging on the left side of her supraglottic region. Serum level of the varicella zoster virus (VZV)-specific IgG was markedly elevated, and a result of genome sequence using the exudates demonstrated VZV as a possible causative pathogen. Fingolimod therapy was discontinued and the patient was successfully treated with intravenous acyclovir. This is the first reported case of fingolimod-associated herpes zoster laryngitis, in which the local VZV reactivation was demonstrated by next-generation sequencing technology. The present case highlights that the occurrence of VZV reactivation should be recalled in any patients undergoing fingolimod therapy.
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Affiliation(s)
- Hideharu Hagiya
- Division of Infection Control and Prevention, Osaka University Hospital, Japan.
| | - Hisao Yoshida
- Division of Infection Control and Prevention, Osaka University Hospital, Japan.
| | - Mikito Shimizu
- Department of Neurology, Osaka University Hospital, Japan.
| | - Daisuke Motooka
- Department of Infection Metagenomics, Research Institute for Microbial Disease, Osaka University, Japan.
| | - Shota Nakamura
- Department of Infection Metagenomics, Research Institute for Microbial Disease, Osaka University, Japan.
| | - Tetsuya Iida
- Department of Infection Metagenomics, Research Institute for Microbial Disease, Osaka University, Japan; Department of Bacterial Infections, Research Institute for Microbial Diseases, Osaka University, Japan.
| | - Norihisa Yamamoto
- Division of Infection Control and Prevention, Osaka University Hospital, Japan.
| | - Yukihiro Akeda
- Division of Infection Control and Prevention, Osaka University Hospital, Japan.
| | - Kazunori Tomono
- Division of Infection Control and Prevention, Osaka University Hospital, Japan.
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