Hoarseness & Submandibula...

A 78-year-old female patient presented to our emergency department with a 5-day history of throat pain, hoarseness and progressive and dolorous submandibular swelling. Due to a non-conclusive clinical examination and the stable but visibly affected patient, a neck CT scan was performed with intravenous contrast, which showed the thumbprint sign. Within minutes, the patient's condition deteriorated, and the patient was close to respiratory exhaustion. As intubation was severely complicated by massive swelling of the supraglottic soft tissue, the patient had hypoxaemia and eventually cardiac arrest. After initiating reanimation protocol, eventually the airway was secured, and return of spontaneous circulation (ROSC) achieved after around 5 min. The initially sampled blood cultures revealed Neisseria meningitidis bacteraemia.