Bilateral Diaphragm Paralysis in Deep Neck Infection: Mimicking Respiratory Distress in Sepsis

Tatsumi Yakushiji, Takahiro Hakozaki, Yuzo Iseki, Satoki Inoue

Abstract


Background: This case report highlights an occurrence of bilateral diaphragm paralysis following surgical drainage for deep neck infection.

Case: A 56-year-old male underwent surgical drainage and tracheostomy for a deep neck infection. Before the second surgical drainage, he exhibited tachypnea (>30 bpm), although his general condition was not significantly compromised. Following a successful drainage procedure, he was transferred to the intensive care unit and placed on mechanical ventilation. Despite attempts at spontaneous breathing trials (SBT), he failed each trial, leading to a deterioration in his general condition. Subsequently, he was diagnosed with diaphragm paralysis.

Conclusion: The clinical manifestations of bilateral diaphragm paralysis closely resemble the common symptoms of sepsis. Therefore, it is crucial to recognize that surgical interventions for deep neck infections may pose a risk of developing diaphragm paralysis, likely associated with phrenic nerve palsy.


Keywords


Deep neck infection; diaphragm paralysis; phrenic nerve palsy; tachepnea

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References


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DOI: http://dx.doi.org/10.21776/ub.jap.2024.005.02.03

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