"Massive hemoptysis" and shock after fever and cough
DENG Liang-Ji, XIONG Jie, ZHONG Li-Li, LIN Xiao-Juan, XIAO Xu-Ping, MAO Zhi-Qun
First Affiliated Hospital of Hunan Normal University/Hunan Provincial Key Laboratory of Pediatric Respiratory Medicine, Children's Medical Center of Hunan Provincial People's Hospital, Changsha 410005, China
Abstract：A boy, aged 11 years, was admitted due to intermittent fever for 15 days, cough for 10 days, and "hemoptysis" for 7 days. The boy had fever and cough with left neck pain 15 days ago, and antibiotic treatment was effective. During the course of disease, the boy developed massive "hemoptysis" which caused shock. Fiberoptic bronchoscopy revealed a left pyriform sinus fistula with continuous bleeding. In combination with neck and vascular imaging examination results, the boy was diagnosed with internal jugular vein injury and thrombosis due to congenital pyriform sinus fistula infection and neck abscess. The boy was improved after treatment with temperature-controlled radiofrequency ablation for the closure of pyriform sinus fistula, and no recurrence was observed during the follow-up for one year and six months. No reports of massive hemorrhage and shock due to pyriform sinus fistula infection were found in the searched literature, and this article summarizes the clinical features, diagnosis, and treatment of this boy, so as to provide a reference for the early diagnosis of such disease and the prevention and treatment of its complications.
James A, Stewart C, Warrick P, et al. Branchial sinus of the piriform fossa: reappraisal of third and fourth branchial anomalies[J]. Laryngoscope, 2007, 117(11): 1920-1924. PMID: 17878800. DOI: 10.1097/MLG.0b013e31813437fc.
Ahn D, Sohn JH, Kim H, et al. Clinical and microbiological differences between pyriform sinus fistulae in pediatric and non-pediatric patients[J]. Auris Nasus Larynx, 2015, 42(1): 34-38. PMID: 25183403. DOI: 10.1016/j.anl.2014.06.003.
Watson GJ, Nichani JR, Rothera MP, et al. Case series: endoscopic management of fourth branchial arch anomalies[J]. Int J Pediatr Otorhinolaryngol, 2013, 77(5): 766-769. PMID: 23478017. DOI: 10.1016/j.ijporl.2013.02.007.
