Tongue protrusion as the presenting symptom of parapharyngeal abscess
- Resource Type
- article
- Authors
- Timothy Visclosky; Sarah Tomlinson; Lauren Bohm; Andrew Hashikawa
- Source
- Journal of the American College of Emergency Physicians Open, Vol 2, Iss 1, Pp n/a-n/a (2021)
- Subject
- deep neck space infections
parapharyngeal abscess
pediatric emergency
tongue protrusion
Medical emergencies. Critical care. Intensive care. First aid
RC86-88.9
- Language
- English
- ISSN
- 2688-1152
Abstract Deep neck space infections are commonly seen in the pediatric population. The diagnosis, however, can be challenging to make and requires a high degree of suspicion because of developmental and age‐related factors in children and non‐specific presenting symptoms. Diagnosis becomes further complicated in patients whose comorbid conditions mask some of the more severe systemic symptoms. We present a case of a 2‐year‐old female with Trisomy 21 who presented with a chief concern of “tongue swelling” per parents. After initially failing treatment for presumed angioedema caused by an angiotensin‐converting enzyme inhibitor, she was ultimately diagnosed with a parapharyngeal abscess with extension and mass effect causing tongue protrusion. This case represents a novel early presentation of a common infection and highlights the challenges of diagnosing deep neck space infections in children.