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September 1989

Acute Suppurative Adenoiditis

Author Affiliations

Department of Pediatrics
Department of Surgery Otolaryngology–Head and Neck Surgery Service Madigan Army Medical Center Tacoma, WA 98431-5000

Am J Dis Child. 1989;143(9):998. doi:10.1001/archpedi.1989.02150210014005

Sir.—A case of isolated adenoiditis prompted a search of the literature for the condition. The results of the search were startling due to the virtual absence of characterization of what should be a distinctive, and not unusual, clinical entity.

Patient Report.—A previously healthy 9-year-old girl presented with fever, rhinorrhea, pharyngeal pain, and hyponasal speech of 2 days' duration. She reportedly had had a tonsillectomy and adenoidectomy 3 years earlier for recurrent adenotonsillitis. Abnormalities on physical examination were limited to fever (temperature, 40°C), serous rhinorrhea that prompted nearly constant sniffling, total occlusion of the posterior nasal airway, and an exudative fullness just visible in the superior pharynx behind the uvula. Mild posterior cervical adenopathy was also present. A lateral soft-tissue roentgenogram of the head and neck was obtained (Figure). The postero-superior location and contour of the naso-pharyngeal mass seen on the roentgenogram suggested adenoid hypertrophy. Flexible fiberoptic nasopharyngoscopy revealed

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