SHM Converge Scientific Abstract ePoster Gallery-An Obscure Case of Retro-Pharyngitis

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This case report describes a 32-year-old woman with a history of substance use, anxiety, and depression who presented with facial erythema, oral ulcers, bilateral conjunctival hemorrhages, tachycardia, tachypnea, marked leukocytosis, and elevated lactate. Physical exam also showed multiple lacerations on her arms and thighs. CT imaging revealed retropharyngitis with phlegmonous changes plus left parotid and submandibular sialadenitis, but no drainable abscess.<br /><br />Retropharyngitis is usually caused by an upper respiratory infection, but this case highlights that blunt neck trauma, including strangulation, can also trigger or worsen deep neck inflammation. The patient was treated with broad-spectrum antibiotics and dexamethasone to reduce the risk of airway compromise. Blood cultures grew Staphylococcus epidermidis in one set and viridans group streptococci in another.<br /><br />A key turning point occurred when the patient’s therapist informed the medical team that she had attempted suicide by inhaling cocaine and strangling herself. The authors emphasize that in patients with depression and facial petechiae or conjunctival hemorrhages, recent strangulation should be strongly suspected and suicide risk carefully assessed. Although petechiae are not specific for strangulation, they can indicate a potentially life-threatening injury when the clinical history supports it.<br /><br />The patient was ultimately transferred to inpatient psychiatry after medical stabilization. The report underscores the importance of considering strangulation as an underlying cause of retropharyngeal inflammation in patients with psychiatric risk factors and visible signs of neck trauma.

Asset Subtitle

Yuhong Yang

Meta Tag

Author List Destiny Nguyen, Erica Grabscheid, Hong Yu Wang, Vani George, Yuhong Yang

Category Clinical Vignettes

Concept Retropharyngitis

Concept Strangulation

Concept Upper Respiratory Infection

Concept Blunt Neck Trauma

Concept Phlegmon

Distinguished Non-Finalist

Presenter Organization Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel

Presenting Author Yuhong Yang

Track Adult

Keywords

retropharyngitis

strangulation

deep neck infection

conjunctival hemorrhage

facial petechiae

substance use

suicide attempt

sialadenitis

phlegmon

psychiatric risk

Retropharyngitis

Strangulation

Upper Respiratory Infection

Blunt Neck Trauma

Phlegmon