Anterior Cricoid Abscess with a Posterior Granuloma: A Dual Pathology

TL;DR

This paper reports a rare case of an anterior cricoid abscess combined with a posterior granuloma and highlights the importance of early diagnosis and management to prevent severe complications.

Contribution

The paper presents the first reported case of an anterior cricoid abscess combined with a posterior granuloma.

Findings

A 60-year-old patient was successfully treated with endoscopic excision and antibiotic therapy for a rare dual pathology.

Early detection and management prevented the need for tracheostomy in this case.

The case emphasizes the importance of considering multiple pathologies in patients with laryngeal symptoms.

Abstract

Cricoid abscesses are rare, typically occurring in the posterior part of the cricoid and are often life-threatening. In this paper, we describe the first reported case of an anterior cricoid abscess and discuss our management.

A 60-year-old lady presented with dyspnoea for 2 days and progressive hoarseness for 8 months. A contrast-enhanced computed tomography revealed a posterior soft tissue thickening and an anterior subglottic collection. The patient underwent endoscopic excision of the granuloma and drainage of the abscess. She completed 3 weeks of oral ciprofloxacin. Subsequent follow-up revealed a patent airway.

We were highly suspicious, as stridor is unlikely to be caused solely by a posterior granuloma. Clinicians should remain alert to the possibility of a second pathology, and early imaging should be performed when clinically indicated. The rarity of a cricoid abscess necessitates a high index of suspicion for diagnosis. In this case, progressive laryngeal lumen narrowing caused by posterior granuloma and cricoid abscess facilitated early symptom detection and timely management, thereby averting tracheostomy.

Figures