Refractory and Relapsing Laryngeal Edema Possibly Associated With Chronic Tonsillitis and Mycoplasma Infection, Requiring Reintubation and Tracheostomy

难治性和复发性喉头水肿可能与慢性扁桃体炎和支原体感染有关,需要再次插管和气管切开术

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Abstract

Relapsing epiglottitis has rarely been reported, and its etiology is not well established. A 44-year-old previously healthy Japanese man presented with a quickly progressing choking sensation. He had been experiencing refractory and relapsing laryngeal edema and probably acute epiglottitis (three episodes within 2 weeks), with rash and elevated pancreatic amylase. The patient required immediate intubation. After the initial extubation, he required reintubation and a subsequent tracheostomy. Antibiotics, glucocorticoid, and antihistamines were administered, and he finally recovered with the tracheostomy's closure. Potential causes of this patient's relapsing epiglottitis are as follows: persistent right swollen tonsil; a positive result on a Mycoplasma pneumoniae antigen test and a particle agglutination (PA) test, implicating chronic tonsillitis; and/or Mycoplasma infection. This is the first case report of refractory and relapsing epiglottitis requiring reintubation possibly concurrent with chronic tonsillitis and Mycoplasma infection.

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