Parapharyngeal abscess complicated by endophthalmitis: A rare presentation of nasopharyngeal carcinoma

V. E S Tan, J. Jeevanan, B. R. Lee

    Research output: Contribution to journalArticle

    3 Citations (Scopus)

    Abstract

    Objective: We report an extremely rare case of nasopharyngeal carcinoma presenting as a lateral neck abscess complicated by endogenous bacterial endophthalmitis. Endogenous bacterial endophthalmitis complicating a neck abscess has not been reported in the recent English literature. We discuss the possible pathophysiology of neck abscess as a presenting feature of nasopharyngeal carcinoma, and the relationship between the parapharyngeal abscess and endogenous bacterial endophthalmitis. Case report: A middle-aged Chinese man presented with a left neck abscess associated with progressive vision deterioration and proptosis of the left eye. Incidentally, his random blood glucose was found to be elevated. Nasal endoscopy also revealed bilateral bogginess in the fossa of Rosenmuller. A diagnosis of left neck abscess with endogenous endophthalmitis associated with underlying diabetes mellitus was made. A computed tomography scan of the neck showed a left parapharyngeal abscess. Incision and drainage of the abscess together with biopsy of the nasopharynx was performed. Due to the non-salvageable condition of the left eye, evisceration was also performed. Pus culture studies from the neck abscess grew Klebsiella pneumoniae, and nasopharyngeal biopsy revealed undifferentiated carcinoma. Conclusion: Nasopharyngeal carcinoma is endemic in South East Asia and can have multiple, varied presentations. Therefore, in this setting, the clinician should have a high index of suspicion, especially in a patient from the Chinese ethnic group.

    Original languageEnglish
    Pages (from-to)867-870
    Number of pages4
    JournalJournal of Laryngology and Otology
    Volume122
    Issue number8
    DOIs
    Publication statusPublished - Aug 2008

    Fingerprint

    Endophthalmitis
    Abscess
    Neck
    Eye Evisceration
    Literature
    Biopsy
    Nasopharyngeal carcinoma
    Exophthalmos
    Far East
    Nasopharynx
    Suppuration
    Klebsiella pneumoniae
    Nose
    Ethnic Groups
    Endoscopy
    Blood Glucose
    Drainage
    Diabetes Mellitus
    Tomography
    Carcinoma

    Keywords

    • Abscess
    • Diabetes Mellitus
    • Nasopharynx Neoplasms
    • Neck

    ASJC Scopus subject areas

    • Otorhinolaryngology

    Cite this

    Parapharyngeal abscess complicated by endophthalmitis : A rare presentation of nasopharyngeal carcinoma. / Tan, V. E S; Jeevanan, J.; Lee, B. R.

    In: Journal of Laryngology and Otology, Vol. 122, No. 8, 08.2008, p. 867-870.

    Research output: Contribution to journalArticle

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