title: An unusual presentation of an infected vallecular cyst presenting as supraglottitis.
abstract: A 50-year-old gentleman presented to the emergency department with a 24 h history of stridor, dysphonia, dysphagia and vomiting. On examination, the patient had fever and tachycardic. There was no palpable cervical lymphadenopathy. Flexible nasendoscopy and lateral neck x-ray revealed soft tissue swelling around the epiglottis. The swelling subsided with conservative management of intravenous antibiotics and steroids, only to later reveal a vallecular cyst, which was confirmed on microlaryngoscopy. The cyst was subsequently deroofed and sent for biopsy. Histological examination revealed an infected, benign vallecular cyst consisting of a squamous epithelium with underlying lymphoid tissue. In adults, vallecular cysts are usually asymptomatic, but can become infected and initiate acute supraglottitis, potentially leading to life-threatening airway obstruction. The case described here, although rare, highlights how early definitive diagnosis and management of vallecular cysts can lead to significantly improved patient outcomes.
authors.affiliation: Bristol Medical School, University of Bristol, Bristol, UK. vp8253@bristol.ac.uk
authors.forename: Vijay
authors.initials: V
authors.lastname: Pattni
authors.forename: Graham
authors.initials: G
authors.lastname: Porter
authors.forename: Eugene
authors.initials: E
authors.lastname: Omakobia
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy; D003560:Cysts / Q000175:diagnosis* / Q000188:drug therapy*; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D013256:Steroids / Q000627:therapeutic use; D059525:Supraglottitis / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D013256:Steroids