Consecutive Severe Orofacial Complications in Intensive Care Unit Patients: Quincke’s Disease and Macroglossia due to Prolonged Prone Positioning for Management of Acute Respiratory Distress Syndrome
  • Nabil Belfeki
    Department of Internal Medicine, Groupe Hospitalier Sud Ile de France, Melun, France
  • Souheil Zayet
    Department of Infectious Diseases, Hôpital Nord Franche-Comté, Trévenans, France
  • Oumar Sy
    Department of Intensive Medicine, Groupe Hospitalier Sud Ile de France, Melun, France
  • Louis Marie Coupry
    Department of Intensive Medicine, Groupe Hospitalier Sud Ile de France, Melun, France
  • Sandy Mazerand
    Department of Intensive Medicine, Groupe Hospitalier Sud Ile de France, Melun, France
  • Ibrahim Chouchane
    Department of Imaging, Groupe Hospitalier Sud Ile de France, Melun, France
  • Cyrus Moini
    Department of Cardiology, Groupe Hospitalier Sud Ile de France, Melun, France
  • Mehran Monchi
    Department of Intensive Medicine, Groupe Hospitalier Sud Ile de France, Melun, France
  • Arsène Mekinian
    Department of Internal Medicine, Hôpital Saint Antoine, Assistante Publique des Hôpitaux de Paris (AP-HP), Paris, France

Keywords

Intensive care unit, Quincke’s disease, acute respiratory distress syndrome, macroglossia, prone positioning

Abstract

Critically ill patients admitted into the intensive care units are susceptible to a wide array of complications that can be life-threatening, or lead to long-term complications. Some complications are inherent to the patient’s condition and others are related to therapeutics or care procedure. The prolonged prone positioning and mechanical ventilation devices are the first risk factors for orofacial complications. We report the case of a 47-year-old male patient, with a history of sleep apnoea syndrome, morbid obesity (body mass index of 43 kg/m2), and gastroesophageal reflux disease, presented to the emergency department with recent otorhinolaryngological symptoms of dysphonia and exertional dyspnoea lasting two days, and complicated with Quincke’s disease. First-line treatment consisted of a compilation of intravenous antihistamines and corticosteroids. The patient’s condition worsened. He developed an acute respiratory distress syndrome secondary to ventilator-acquired pneumonia with prone positioning ventilation, complicated by severe macroglossia. Soaked gauze dressings were placed around his tongue. Progressively, the size of his tongue reduced.

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    Published: 2022-08-24
    Issue: 2022: Vol 9 No 8 (view)

    How to cite:
    1.
    Belfeki N, Zayet S, Sy O, Coupry LM, Mazerand S, Chouchane I, Moini C, Monchi M, Mekinian A. Consecutive Severe Orofacial Complications in Intensive Care Unit Patients: Quincke’s Disease and Macroglossia due to Prolonged Prone Positioning for Management of Acute Respiratory Distress Syndrome. EJCRIM 2022;9 doi:10.12890/2022_003241.

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