1/5. Ultrasound-guided drainage of peritonsillar abscess by the emergency physician.The diagnosis of peritonsillar abscess (PTA) poses a challenge to emergency physicians (EPs). The decision to perform an invasive procedure with potential complications is based on clinical judgment that is often inaccurate. Although there is some mention of intraoral ultrasound in otolaryngology practice, there is none in the emergency medicine (EM) literature. However, this bedside emergency application of ultrasonography has the potential to be of considerable use in EM practice, and could allow EPs who previously deferred blind needle aspiration of a potential abscess to perform the procedure themselves. We report the cases of 6 patients who presented with probable PTA and were evaluated with intraoral ultrasound at the bedside by an EP. All 6 patients then underwent needle aspiration. As diagnosed on ultrasound, 3 of the patients had negative aspirations and were diagnosed with peritonsillar cellulitis. Three others were found to have PTA, with 2 requiring real-time ultrasound needle guidance to accomplish abscess drainage after multiple failures with the blind approach.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/5. Chron's disease, rare association with selective IgA immunodeficiency, and development of life-threatening bacterial infections.life-threatening necrotizing fasciitis and relapsing lemierre syndrome associated with fusobacterium necrophorum septicaemia occurred in young adults with a moderate Chron's disease and a missed profound iga deficiency. This unexpected association of a chronic bowel inflammatory syndrome with prominent IgA abnormalities and severe bacterial infection deserves careful attention by physicians faced with young patients with Chron's disease.- - - - - - - - - - ranking = 0.2keywords = physician (Clic here for more details about this article) |
3/5. Vascular complication of neck space infection: case report and literature review.Antibiotic therapy has changed the face of medicine radically, and physicians no longer have the empirical knowledge of bacterial infections that they once had. Consequently, the diagnosis and management of complicated infections presents a significant challenge to today's otolaryngologists. We present a rare complication, even before the advent of antibiotics, of a head and neck infection: a carotid artery pseudoaneurysm resulting from peritonsillar abscess. The diagnosis and management of this problem is discussed and the pertinent literature reviewed.- - - - - - - - - - ranking = 0.2keywords = physician (Clic here for more details about this article) |
4/5. Retropharyngeal calcific tendinitis: report of five cases and review of the literature.Retropharyngeal calcific tendinitis is an inflammation of the longus colli muscle tendon, which is located on the anterior surface of the vertebral column extending from the atlas to the third thoracic vertebra. Five cases of acute retropharyngeal calcific tendinitis seen in the emergency department (ED) over a 15-month period are reported. In addition, a retrospective review of four cases diagnosed as retropharyngeal abscess and admitted to the hospital revealed that two of these cases actually represented retropharyngeal calcific tendinitis. A review of the literature and potential differential diagnoses are presented. For those primary care physicians who must evaluate patients with acute cervical pain, sore throat, or odynophagia, an x-ray study of the neck revealing retropharyngeal calcium deposition should raise the question of the diagnosis of acute retropharyngeal tendinitis. Clinical characteristics of this entity include a painful condition which is treatable and is often mistaken for retropharyngeal abscess, pharyngitis, or peritonsillar abscess. In our opinion, this condition may be more prevalent than the literature suggests.- - - - - - - - - - ranking = 0.2keywords = physician (Clic here for more details about this article) |
5/5. Carotid hemorrhage: a complication of peritonsillar abscess.Carotid hemorrhage secondary to peritonsillar abscess occurs infrequently today because of the effectiveness of antibiotic therapy. When it does occur, however, emergency physicians unfamiliar with such a complication may have difficulty making its diagnosis and instituting appropriate therapy. Prevention is the easiest way to treat septic erosion. Abscesses are treated best with penicillin or, in the allergic patient, clindamycin followed by incision and drainage. Once the abscess has eroded into the carotid artery, it usually must be tied off to control the subsequent massive bleeding.- - - - - - - - - - ranking = 0.2keywords = physician (Clic here for more details about this article) |