Fatal sore throat

Introduction:

Acute sore throat is a common complaint in otolaryngology consultations. The causes are usually diseases such as self-limiting viral pharyngitis or bacterial infections that are treated with antibiotics. However, these everyday symptoms can hide potentially life-threatening illnesses, as our case clearly shows.

Case report:

A 62-year-old woman presented with the family physician's referral with diagnosis of quinsy and right-sided sore throat since several days. In the past medical history, the patient underwent tonsillectomy. In medication history the patient used to take Novalgin® for a longer time because of calf pain. In clinical examination we found around two ulcers, each one was around one centimeter, elongated and greasy on the right pharyngeal wall and in the base of the tongue, the other otolaryngogical clinical examinations were insignificant. The general condition of the patient was significantly deteriorated and we decided to admit her in hospital. In lab results, a marked pancytopenia and a generalized disturbance of the coagulation parameters were noted. Therefore she was immediately transferred to the department of hematology and oncology. The patient died after four days with intracranial hemorrhage even after initiation of the intensive care treatment.

Conclusion:

Agranulocytosis is a rare and serious side effect that can be caused by Metamizol (Novalgin®). Due to the initial nonspecific symptoms, the problem often is diagnosed late therefore delaying the treatment. The ORL physician has an important role in treating such complaints and leading to an early management of patients.

Publication History

Publication Date:
12 June 2019 (online)