Pediatric bilateral vocal cord granulomas presenting as airway foreign body following prolonged intubation due to COVID-19 related multisystem inflammatory syndrome

Viraj N Shah; Neeraj V Suresh; Luke J Pasick; Michael K Ghiam; Leonardo A Torres

doi:10.1016/j.xocr.2021.100311

Pediatric bilateral vocal cord granulomas presenting as airway foreign body following prolonged intubation due to COVID-19 related multisystem inflammatory syndrome

Otolaryngol Case Rep. 2021 Sep:20:100311. doi: 10.1016/j.xocr.2021.100311. Epub 2021 Apr 27.

Authors

Viraj N Shah¹, Neeraj V Suresh¹, Luke J Pasick¹, Michael K Ghiam¹, Leonardo A Torres¹

Affiliation

¹ Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.

Abstract

Background: This report is a case of bilateral vocal cord granulomas (VCG) in a 9-year-old child presenting as an airway foreign body and stridor following prolonged intubation due to COVID-19 pneumonia complicated by multisystem inflammatory syndrome in children (MIS-C).

Case presentation: This case reports a 9-year-old male who presented to the emergency department with acute stridor concerning for airway obstruction. X-ray findings suggested an airway foreign body; however, on rigid bronchoscopy, ball-valving bilateral VCG obstructing 90% of the glottic airway were identified. After excision of the VCGs, the patient's symptoms resolved with no postoperative complications.

Conclusion: With suspected foreign body aspiration in a pediatric patient with a history of prolonged intubation, it is important to consider a broad differential diagnosis. VCGs are rare complications of prolonged intubation that could be in children with prior history of intubation following COVID-19 pneumonia.

Keywords: COVID-19; Foreign body; Multisystem inflammatory syndrome; Pediatric; Vocal cord granulomas.

Publication types

Case Reports