Feather foreign body caused periparotid and peritonsillar abscess in a 9-month-old girl

• Published in: Auris, nasus, larynx Vol. 48; no. 5; pp. 1023 - 1025
• Main Authors: Gabelica, Mirko, Tafra, Robert, Martinić, Marina Krnić, Kontić, Mirko, Markić, Joško, Kovačević, Tanja, Čagalj, Ivana Čulo, Ninčević, Željko
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-10-2021
• Subjects: Abscess - diagnostic imaging; Abscess - etiology; Abscess - therapy; Animals; Anti-Bacterial Agents - therapeutic use; Drainage; Feather; Feathers; Female; Foreign Bodies - complications; Foreign Bodies - diagnostic imaging; Foreign Bodies - therapy; Foreign-Body Migration - complications; Foreign-Body Migration - diagnostic imaging; Foreign-Body Migration - therapy; Humans; Infant; Migrating foreign body; Neck abscess; Palatine Tonsil - diagnostic imaging; Parotid Region; Periparotid abscess; Peritonsillar abscess; Peritonsillar Abscess - diagnostic imaging; Peritonsillar Abscess - etiology; Peritonsillar Abscess - therapy; Tomography, X-Ray Computed; Ultrasonography; Periparotid abscess; Feather; Migrating foreign body; Peritonsillar abscess; Neck abscess
• ISSN: 0385-8146; 1879-1476
• DOI: 10.1016/j.anl.2020.05.021

Migratory foreign body appeared to be bird feather, caused peritonsillar and periparotid abscess in a nine-month-old infant. Patient presented painful, tender and fluctuating red neck mass on the left neck region II, and refusal of oral intake, with no fever. Azithromycin was introduced four days before presentation for suspected urinary tract infection. ENT examination revealed left peritonsillar abscess; ultrasound confirmed periparotid abscess, MSCT verified both diagnoses. Under general anaesthesia, we performed abscess incision, after pus drainage, small foreign body spontaneously came through the wound. After washing it with saline, it appeared like a bird feather. Subsequently, peritonsillar abscess was incised and drained. After 24-hour postoperative care on pediatric intensive care unit, the patient continued three-day parenteral antibiotic treatment on the otolaryngology department; it was discharged with a recommendation to continue seven days of oral antibiotic therapy. Suggested mechanism was ingestion of bird feather from stuffed bedding, that got trapped in the tonsillar crypt. Afterwards, it started to migrate through the neck tissue. Households with children younger than three years should not have feather stuffed clothes or beddings.