A Case of Esophageal Submucosal Abscess Originating from a Peritonsillar Abscess

• Published in: Nippon Jibi Inkoka Gakkai Kaiho Vol. 119; no. 7; pp. 962 - 966
• Main Authors: Inoue, Mami, Okamoto, Kotaro, Nagao, Hikaru, Toyoda, Kenichiro
• Format: Journal Article
• Language: Japanese
• Published: Japan The Oto-Rhino-Laryngological Society of Japan, Inc 01.07.2016
• Subjects: Abscess - diagnosis; Abscess - etiology; Drainage; Esophageal Diseases - diagnosis; Esophageal Diseases - etiology; esophageal submucosal abscess; Humans; Male; Middle Aged; peritonsillar abscess; Peritonsillar Abscess - complications; Peritonsillar Abscess - diagnosis; Streptococcal Infections - complications; Streptococcus constellatus - isolation & purification; Streptococcus milleri group
• ISSN: 0030-6622; 1883-0854
• DOI: 10.3950/jibiinkoka.119.962

We report the case a 54-year-old male patient who was admitted to our hospital with a sore throat and evidence of a high inflammatory reaction. Computed tomography revealed a peritonsillar abscess extending from the inferior right tonsil to the cervical esophagus, and thickening of the esophageal wall. The pharyngeal abscess was drained through an intraluminal incision in the mesopharynx. Culture of the abscess fluid showed growth of Streptococcus constellatus, one of the organisms of the Streptococcus milleri group. We diagnosed the patient as having phlegmonous esophagitis secondary to peritonsillar abscess. The inflammation was judged to have extended to the submucosal space of the esophagus from the pharyngeal mucosal space. Since the inflammation was contained within the esophageal wall and did not progress to mediastinitis, critical symptoms did not appear and the patient improved through conservative management with antibiotics.