A rare case of tuberculous abscess causing airway obstruction in a paediatric patient in South-East Asia

Abstract EN

A 6-year old girl, presented with symptoms of obstructive sleep apnoea.

she was referred to our centre when she developed obstructive symptoms such as stridor and dysphagia a month later.

she was found to have a right neck swelling with a posterior pharyngeal wall mass, which caused upper airway obstruction.

a computerized-tomography scan of her neck showed a very narrowed upper airway with a retropharyngeal ESS without prevertebral or vertebral involvement.

she had a challenging intubation and underwent an emergency intraoral incision and drainage.

pus that was drained revealed acid fast bacilli and histopathological examination showed necrotizing granulomatous inflammation, in favour of a tuberculous ESS.

post operatively, her symptoms resolved and her intraoral wound healed.

she completed anti-tuberculous treatment and has remained well at 6 months follow up.

our case illustrates how a cold retropharyngeal ESS can masquerade as obstructive sleep apnoea, with a compromised airway as it increases in size.