Aggressive Spreading Pharyngitis, CT
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This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0129-Aggressive Spreading Pharyngitis, CT
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CA0129-Aggressive Spreading Pharyngitis, CT
Case ReportHistory
Exam
Findings
Nasopharynx Including Retropharyngeal Lymph Nodes
There is some hypertrophy of the nasopharyngeal lymphoid tissue. There is no edema or other abnormalities in the adjacent deep tissue spaces.
Oropharynx Including Retropharyngeal Lymph Nodes
There is no edema or other abnormalities involving the oropharynx or adjacent deep tissue spaces.
The tonsillar and lingual lymphoid tissue appears prominent. In addition, there is edema in the vallecula and extensive right parapharyngeal space edema, extending as high as the submandibular space.
Oral Cavity, Floor of the Mouth, Maxilla and Mandible
There is no edema or other abnormalities within or surrounding the buccal space, masticator space, floor of the mouth or the adjacent superficial fascia or subcutaneous fat and skin.
Hypopharynx, Larynx, Deep Neck and Entire Retropharyngeal Space
There is thickening of the mucosa within in the hypopharynx and larynx, most prominent on the right side with extensive edema of the right pharyngeal wall, the posterior pharyngeal wall the aryepiglottic folds, the epiglottis, the right false vocal folds and the right true vocal cord. The airway is moderately narrowed in the supraglottic region.
The thyroid gland or trachea are normal.
There is edema within the visceral compartment and right deep neck spaces with extension as high as the submandibular space. There is minimal retropharyngeal edema.
Major Salivary Glands
The right submandibular gland is enlarged and shows increased enhancement. There are periglandular inflammatory changes in continuity with the inflammation as described above.
The parotid, left submandibular and sublingual glands are not enlarged and do not show normal enhancement.
Prevertebral and Epidural Spaces
There is no edema or other abnormality within in the prevertebral, paravertebral or epidural spaces.
Cervical Lymph Nodes
There is reactive cervical lymphadenopathy in level 2 and 3 on both sides and in level 4 on the left.
Vascular Findings
There is no evidence of thrombus, thrombophlebitis or other occlusive or inflammatory process of the jugular vein or smaller venous tributaries.
There is no evidence of thrombus, inflammation of the common, external or internal carotid artery. There is no evidence of active extravasation or a contained leakage from an arterial source.
Upper Lung Zones and Mediastinum
The upper lung zones and mediastinum visualized are normal.
Other Findings
There is extensive periodontal, periapical disease and caries in the second premolar and third molar in the left-sided mandible and the second molar in the right maxilla. The first and second molars are missing. There are sclerotic bone changes in the posterior mandibular body and ramus.
Impression
The airway is moderately narrowed in the supraglottic region.
