SHM Converge Scientific Abstract ePoster Gallery-Lung Abscess in Late Dysphagic Patient After Laryngeal Schwannoma Resection

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A 27-year-old man presented to the emergency department with one week of fever, night sweats, anorexia, and productive brown sputum, along with chronic dysphagia that began after resection of a laryngeal schwannoma 15 years earlier. He was mildly febrile, tachycardic, and tachypneic, with leukocytosis and elevated inflammatory markers. Imaging showed a left upper lobe lung abscess.<br /><br />Because lung abscesses are often caused by aspiration, clinicians evaluated whether his long-standing swallowing difficulty contributed to the infection. He was started on empiric ampicillin-sulbactam and improved rapidly. Infectious workup, including sputum culture and testing for tuberculosis and endemic fungi, was negative. A videofluoroscopic swallowing study confirmed moderately compensated oropharyngeal dysphagia.<br /><br />During treatment, he developed ampicillin-sulbactam–induced liver injury, so antibiotics were changed to levofloxacin plus metronidazole for four weeks. He was discharged with follow-up arranged with primary care, otolaryngology, pulmonology, and speech-language pathology. Follow-up imaging showed complete resolution of the abscess with residual scarring.<br /><br />This case highlights a rare late complication of laryngeal schwannoma resection: persistent dysphagia leading to aspiration and lung abscess. Since laryngeal schwannomas are uncommon and postoperative long-term swallowing complications are not well defined, the authors emphasize the importance of assessing aspiration risk in patients with prior benign laryngeal tumor surgery and involving speech-language pathology in chronic dysphagia management.

Asset Subtitle

Stephanie Batch

Meta Tag

Author List Aditi Sharma, Stephanie Batch, Zai Ganesh

Category Clinical Vignettes

Concept Lung Abscess

Concept Swallowing Impairment

Concept Aspiration

Concept Laryngeal Schwannoma

Concept Antibiotic Therapy

Distinguished Non-Finalist

Presenter Organization University of Texas Health Science Center San Antonio

Presenting Author Stephanie Batch

Track Adult

Keywords

lung abscess

laryngeal schwannoma

dysphagia

aspiration

oropharyngeal dysphagia

ampicillin-sulbactam

liver injury

levofloxacin

metronidazole

speech-language pathology

Lung Abscess

Swallowing Impairment

Aspiration

Laryngeal Schwannoma

Antibiotic Therapy