Abstract

Case Report

Lincoln ’S Highway - A Forgotten Abscess

Suhail Amin Patigaroo*, Zubair Ahmad Lone, Quratul Ain Batool and Sajad Majid Qazi

Published: 23 March, 2017 | Volume 1 - Issue 1 | Pages: 011-015

Introduction: Carotid space is a deep neck space within the carotid sheath. .Mosher called carotid sheath as the Lincoln Highway of the neck. Abscess in this space is rare to be seen by young Ear, Nose and Throat (ENT) surgeons in this era of early diagnosis and good antibiotics. We are reporting a case of isolated carotid space abscess in a 20 year old male to familiarize young surgeons with this abscess.

Case report: A 20 year old young boy came to our Outpatient Department (OPD) with complaints of fever, painful neck swelling, progressive difficulty in swallowing from the last 7 days. Contrast Enhanced Computed Tomography (CECT) was done which revealed abscess located adjacent to carotid artery in the carotid sheath. Incision and drainage was done and carotid sheath was opened and pus drained .Patient was discharged after few days on oral antibiotics.

Conclusion: Carotid space abscesses are rarely seen in developed countries. Tender and fluctuating swelling over the carotid artery area points towards it. CECT is the investigation of choice. Needle aspiration should be avoided especially by less trained persons. Small abscesses may respond to intravenous antibiotics but when frank and large abscess is formed, incision and drainage is the treatment of choice.

Read Full Article HTML DOI: 10.29328/journal.hor.1001003 Cite this Article Read Full Article PDF

References

  1. Byron J Bailey, Jonas T Johnson, Shawn D Newlands. Head and Neck Surgery-Otolaryngology. Fourth Edition. 2006; 670. Ref.: https://goo.gl/W8OvIU
  2. Patigaroo SA, Patigaroo FA, Mehfooz N, Khan NA, Kirmani MH, et al. Pediatric Deep Neck Space Abscesses: A Prospective Observational Study. Emergency Med. 2012; 2. Ref.: https://goo.gl/lQva5X
  3. Anithakumari AM, Girish RB. Carotid Space Infection: A case report. Indian J Otolaryngol Head Neck Surg. 2006; 58: 95-97. Ref.: https://goo.gl/XYtqUg
  4. Cummings Otolaryngology Head & Neck Surgery. 4th edition Mosby. 2005; chapter 110.
  5. Ossowski K, Chun RH, Suskind D, Baroody FM. Increased isolation of methicillin-resistant Staphylococcus aureus in pediatric head and neck abscesses. Arch Otolaryngol Head Neck Surg. 2006; 132: 1176-1181. Ref.: https://goo.gl/p2cGwZ
  6. Baldassari CM, Howell R, Amorn M, Budacki R, Choi S. Complications in pediatric deep neck space abscesses. Otolaryngol Head Neck Surg. 2011; 144: 592-595. Ref.: https://goo.gl/XLa7aJ
  7. Khan A Nazir, Patigaroo FA, Mudasir ul ilam, Ahmed Shakil, Patigaroo SA. Paediatric acute retropharyngeal abscesses: An experience. African Journal of Paediatric Surg. 2013; 10: 327-335. Ref.: https://goo.gl/Y3zRLd
  8. Patigaroo SA, Ahangar S, Rashid W. Acute retropharyngeal abscess with torticollis and cervical subluxation-A case report and review of literature. International Journal of Pediatric Otorhinolaryngology. 2011; 6: 252-255. Ref.: https://goo.gl/CV1Fx9

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