Treatment for a Rare Case of Pharyngitis Progressed to Supraglottis and Necrosis
In November 2022, Caroll Pellegrin felt unwell and saw his primary care provider with a worsening sore throat and “a little cough.” He tested negative for COVID-19, influenza, and strep throat. The following day he was unable to swallow and presented at an urgent care clinic, where the tests were repeated, again with negative results.
“By the third day Caroll’s neck was swollen up like a bullfrog and he couldn’t catch his breath,” says his wife Connie Pellegrin. He was taken by ambulance to the emergency department at Memorial Hermann The Woodlands Medical Center, where he was seen by Douglas Stanley, MD, an assistant professor in the Department of Otorhinolaryngology at McGovern Medical School at UTHealth Houston.
“Mr. Pellegrin had supraglottis that had progressed to life-threatening airway obstruction, so we intubated him through the nose and took him to the OR that night,” Dr. Stanley says. “When we opened his neck, we found and removed a lot of necrotic tissue. We were concerned that the necrosis would spread further, so we packed his neck with gauze soaked in antiseptic solution and sent him to intensive care intubated.”
Over the next week and a half, Dr. Stanley took Pellegrin back to the OR six times to remove necrotic tissue. When the necrosis stabilized, he placed a tracheostomy in a low position to avoid further contamination of the wound.
“Caroll has little memory of this time, but it was really frightening,” Connie Pellegrin says. “There were many times when we thought we’d lost him.”
When the infection stabilized, Dr. Stanley and his team weaned Pellegrin from mechanical ventilation and closed the wound. He progressed through the hospital in three weeks and was discharged to TIRR Memorial Hermann-The Woodlands for two weeks of inpatient rehabilitation that included swallow and speech therapy, as well as physical and occupational therapy to help him regain lost strength. He completed three more months of the same therapy on an outpatient basis.
“Mr. Pellegrin endured a very rare and unfortunate progression of infection caused by a strain of fast-moving bacteria,” Dr. Stanley says. “His wife never left the hospital the entire time he was with us. It always helps to have someone by your side, but she was awesome – incredibly supportive and very informed about his condition.”
“We are Christians,” she says. “We put this in God’s hands from the beginning and left the burden there.”
Caroll Pellegrin says it has taken him many months to process the experience. “I had to piece together the reality from what I saw when I was in a dreamlike state in the ICU and what Connie told me. Dr. Stanley came up every day and checked on us,” he says. “He saved my life, and he is our hero.”