ABSTRACT
Sarcoidosis is a rare multisystem disorder of unknown aetiology characterised by non-caseating granulomas in involved organs; it is a diagnosis of exclusion. Laryngeal involvement affects only 0.5%-5% of those with sarcoidosis. It is an uncommon but important cause of supraglottic inflammation and oedema and should be considered in the differential diagnosis in patients with supraglottitis. This case describes a 30-year-old man who presented with stridor and shortness of breath. Flexible nasendoscopic examination revealed a grossly oedematous, pale pink, diffusely hypertrophied epiglottis. Surgical biopsy revealed non-caseating granulomatous inflammation. In the context of exclusion of hepatitis, anti-neutrophil cytoplasmic antibody (ANCA) positivity, malignancy and mycobacterial infection, the diagnosis of supraglottic laryngeal sarcoid was made. He is being treated with azathioprine immunosuppression with symptomatic improvement.
Subject(s)
Azathioprine/therapeutic use , Laryngeal Diseases/drug therapy , Sarcoidosis/drug therapy , Adult , Diagnosis, Differential , Humans , Immunosuppressive Agents/therapeutic use , Laryngeal Diseases/diagnostic imaging , Male , Missed Diagnosis , Sarcoidosis/diagnostic imaging , Supraglottitis/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
The authors present the case of a 38-year-old female who presented with an ingested oesophageal foreign body (lamb bone) following consumption of a casserole. The bone was initially not seen on plain x-ray but CT imaging revealed a 21×20 mm pyramid shaped bone distending the proximal oesophageal mucosa and lodged only 2 mm from the aortic arch. Cardiothoracic surgery services were available on standby to perform an emergency thoracotomy in the event of any haemorrhage. However, the bone was removed successfully with rigid oesophagoscopy and the patient made a full recovery.
Subject(s)
Aorta, Thoracic/diagnostic imaging , Esophagoscopy , Esophagus/diagnostic imaging , Foreign Bodies/diagnostic imaging , Foreign Bodies/therapy , Tomography, X-Ray Computed , Adult , Bone and Bones , Diagnosis, Differential , Female , HumansABSTRACT
The authors present the case of a 76-year-old male who presented with right-sided recurrent malignant otitis externa (MOE) and skull-base osteomyelitis. His management involved aggressive antimicrobial therapy and multiple hyperbaric oxygen treatments. After resolution of his right-sided infection, the patient returned a short time later with symptoms and findings consistent with new, left-sided MOE with involvement of the left skull-base. With repeat treatment, the patient is now cured of his infection but poses a challenge to the treating team about future management.