Case Study

CT – Diffuse septic cellulitis at the base of the tongue and larynx with regional lymphadenitis in a 7 year old MN Labrador mix

This 7 year old MN Labrador mix presented with drooling, raspy respiratory sounds, decreased eating and drinking.

Physical exam swollen tongue and frenulum, ulcerated area right side of frenulum which ruptured on intubation, releasing purulent material and blood

CBC/Chem: HCT 36.3, WBC 20,000, glob 4.7, chol 429

This 7 year old MN Labrador mix presented with drooling, raspy respiratory sounds, decreased eating and drinking.

Physical exam swollen tongue and frenulum, ulcerated area right side of frenulum which ruptured on intubation, releasing purulent material and blood

CBC/Chem: HCT 36.3, WBC 20,000, glob 4.7, chol 429

DX

The computed tomographic findings are compatible with diffuse septic cellulitis in the area of the base of the tongue and larynx with septic regional lymphadenitis.

Image Interpretation

CT of the head and thorax –

Head: The computed tomography of the head reveals a diffuse soft tissue swelling with increased contrast enhancement and marked peripheral fat stranding centered around the region of the base of the tongue an larynx. The soft tissue swelling involves the pharynx and soft palate, the lumen of the naso- and oropharynx is reduced. The medial retropharyngeal and submandibular lymph nodes present moderate enlargement with maintained shot-to-long-axis < 0.5 and regular enhancement pattern. A true abscess cavity is not seen, neither is a foreign body visible.

Thorax: The computed tomography of the thorax is within normal limits.

Outcome

A true abscess cavity and capsule cannot be identified which may be due to the abscess rupture prior to the CT examination. Even though a foreign body related injury is the most likely underlying cause there is no foreign material detectable. The presence of small pieces of macerated hydrolyzed organic material cannot be ruled out based on negative CT findings.
The potential of a neoplasia is considered low.