Purulent chondritis of the laryngeal framework cartilages.
This manuscript reports on our experience with purulent chondritis of the laryngeal cartilages (PCLC), an entity that has not yet been described. Three patients had a diagnosis of PCLC. The probable causes were relapsing polychondritis, a previous prolonged intubation, and an idiopathic cause. The patients suffered from hoarseness and inspiratory stridor for 1 to 3 months before diagnosis. None complained of pain in the neck. Laryngoscopy showed supraglottic edema. A computed tomography scan revealed abscess formation between the intact inner and outer perichondria of the thyroid cartilage. The treatment included rigid endoscopy, external incision and drainage, and prolonged medical therapy. The culture results were Staphylococcus aureus in the first 2 cases and Aspergillus fumigatus in the third. The second patient (in whom the cricoid cartilage was also affected) required emergency tracheotomy. The other 2 patients did not require airway intervention. The rarity of PCLC and the relatively mild symptoms require a high index of suspicion for its diagnosis.
Eliashar
Ron
R
Department of Otolaryngology-Head and Neck Surgery, The Hebrew University School of Medicine, Hadassah Medical Center, Jerusalem, Israel. ron@eliashar.com
Gross
Menachem
M
Goldfarb
Abraham
A
Sichel
Jean-Yves
JY
D000038:Abscess / Q000000981:diagnostic imaging* / Q000628:therapy; D000368:Aged; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy; D001232:Aspergillus fumigatus; D006685:Hoarseness / Q000209:etiology; D006801:Humans; D007817:Laryngeal Cartilages / Q000382:microbiology*; D007818:Laryngeal Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D010007:Osteochondritis / Q000175:diagnosis* / Q000628:therapy; D011859:Radiography; D012135:Respiratory Sounds / Q000209:etiology; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy; D013211:Staphylococcus aureus