Acquired Hemophilia A Simulating Retropharyngeal Abscess: Importance of Differential Diagnosis of Neck Masses before Surgery

Isabel López-Sánchez¹, José-Ramón Alba-García¹, Cristina Vázquez-Romero¹, Miguel Armengot-Carceller^2*

¹ENT Department, General and University Hospital, Valencia, Spain.
²Rhinology Unit, ENT Department, General and University Hospital.Valencia University, Valencia, Spain.

DOI: 10.4236/ijohns.2015.44048                

Abstract

The coexistence of acquired hemophilia A with a secondary retropharyngeal hematoma is an extremely unusual condition with important clinical implications. The purpose of this paper is to present a case involving a patient whose first clinical manifestation, namely dysphagia, along with specific clinical examination and imaging findings, led to an incorrect initial diagnosis of a retropharyngeal abscess. However, performance of a more thorough clinical examination led to the correct diagnosis of a hematoma secondary to acquired hemophilia A. This allowed surgery to be avoided in a patient at a high risk of bleeding. Conclusions: Acute neck masses require meticulous differential diagnosis assessing the possible presence of various causative systemic diseases before the most appropriate therapy can be determined.

Keywords

Dysphagia, Cervical Inflammation, Coagulopathy, Hematoma, APTT, Parapharyngeal Spaces

Conflicts of Interest

The authors declare no conflicts of interest.

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