{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:40:03Z","timestamp":1756305603087,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,8,25]]},"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:p>A vallecular cyst is a benign laryngeal cyst that rarely causes symptoms in adults. We report a rare case of an infected vallecular cyst in a man who is in his 60s with diabetes mellitus. The patient presented to us with acute onset of voice muffling and respiratory distress. He showed signs of sepsis and upper airway obstruction. He had spikes of high-grade fever with an elevated total white cell count (predominantly neutrophil count) and C reactive protein level. Plain cervical X-ray revealed a large, smooth, lobulated mass in the vallecular area. Direct laryngoscopic findings supported the diagnosis of an infected vallecular cyst with suppuration, which originated from the vallecula fossa. The cyst was drained and excised completely, and the pus culture revealed the presence of <jats:italic>Klebsiella pneumoniae<\/jats:italic>. The patient responded well to the administration of intravenous cefuroxime for 2 weeks according to the sensitivity and culture test. He was discharged after the completion of the course of antibiotics, having recovered fully. This case illustrates the versatility of a plain cervical X-ray in giving clues about this rare, unexpected pathology.<\/jats:p>","DOI":"10.1136\/bcr-2022-250615","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T10:55:58Z","timestamp":1663239358000},"page":"e250615","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Rare cause of voice muffling: pyogenic vallecular cyst"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3984-1408","authenticated-orcid":false,"given":"Lorna Kang Ni","family":"Ting","sequence":"first","affiliation":[{"name":"Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia"},{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anuar","family":"Idris","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9282-874X","authenticated-orcid":false,"given":"Marina","family":"Mat Baki","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,9,15]]},"reference":[{"key":"2025082707025535000_15.9.e250615.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.12.008"},{"key":"2025082707025535000_15.9.e250615.2","doi-asserted-by":"crossref","first-page":"11080","DOI":"10.14260\/jemds\/2015\/1596","article-title":"A rare case of large epiglottic cyst","volume":"4","author":"Sudhakar","year":"2015","journal-title":"J Evol Med Dent Sci"},{"key":"2025082707025535000_15.9.e250615.3","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-0496(199904)27:4<282::AID-PPUL10>3.0.CO;2-G"},{"key":"2025082707025535000_15.9.e250615.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2009.02069.x"},{"key":"2025082707025535000_15.9.e250615.5","doi-asserted-by":"crossref","DOI":"10.1097\/SCS.0000000000002073","article-title":"Vallecular cyst causing dysphagia and stridor","volume":"26","author":"Erdur","year":"2015","journal-title":"J Craniofac Surg"},{"key":"2025082707025535000_15.9.e250615.6","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3126\/njenthns.v3i2.10152","article-title":"Vallecular cysts in adult population: ten year experience","volume":"3","author":"Singhal","year":"2012","journal-title":"Nepalese Journal of ENT Head and Neck Surgery"},{"key":"2025082707025535000_15.9.e250615.7","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1213\/XAA.0000000000000222","article-title":"Airway management of incidental vallecular cysts in adults","volume":"5","author":"Vorobeichik","year":"2015","journal-title":"A A Case Rep"},{"key":"2025082707025535000_15.9.e250615.8","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1177\/0310057X0403200219","article-title":"Airway problems related to laryngeal mask airway use associated with an undiagnosed epiglottic cyst","volume":"32","author":"Kariya","year":"2004","journal-title":"Anaesth Intensive Care"},{"key":"2025082707025535000_15.9.e250615.9","doi-asserted-by":"crossref","first-page":"524","DOI":"10.4103\/0019-5049.89896","article-title":"Acute airway obstruction, an unusual presentation of vallecular cyst","volume":"55","author":"Jahagirdar","year":"2011","journal-title":"Indian J Anaesth"},{"key":"2025082707025535000_15.9.e250615.10","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/81.6.715"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-250615","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:03:03Z","timestamp":1756303383000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-250615"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9]]},"references-count":10,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9,15]]},"published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1136\/bcr-2022-250615"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-250615","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,9]]}}}