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

Yutaka Tsukamoto; Takashi Sugimoto; Masataka Umeda; Yuki Furuse; Haruo Yoshida; Yuka Nagae; Yasuo Ohsato; Yukitaka Ueki; Maeda Takahiro; Koya Ariyoshi

doi:10.1155/carm/6638796

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

Case Rep Med. 2025 Jan 4:2025:6638796. doi: 10.1155/carm/6638796. eCollection 2025.

Authors

Yutaka Tsukamoto¹, Takashi Sugimoto¹, Masataka Umeda^{2

3}, Yuki Furuse⁴, Haruo Yoshida⁵, Yuka Nagae⁶, Yasuo Ohsato⁷, Yukitaka Ueki⁸, Maeda Takahiro³, Koya Ariyoshi¹

Affiliations

¹ Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
² Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
³ Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
⁴ Medical Education Development Center, Nagasaki University Hospital, Nagasaki, Japan.
⁵ Department of Otolaryngology-Head and Neck Surgery, NHO Nagasaki Medical Center, Nagasaki, Japan.
⁶ Department of Respiratory Medicine, Sasebo Chuo Hospital, Sasebo, Nagasaki, Japan.
⁷ Department of Otolaryngology, Sasebo Chuo Hospital, Sasebo, Nagasaki, Japan.
⁸ Rheumatic and Collagen Disease Center, Sasebo Chuo Hospital, Sasebo, Nagasaki, Japan.

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.

Keywords: Mycoplasma; chronic tonsillitis; laryngeal edema; relapsing epiglottitis.

Publication types

Case Reports