CTICasesPolymicrobial Tracheostomy Stoma Infection
Imaging findings
A patient with prior head and neck cancer, surgery, and radiation fibrosis of the lung apices underwent tracheostomy and presented months later with unilateral neck/chest wall swelling, fever, and pain; imaging showed soft tissue stranding and induration extending from the tracheostomy stoma. Surgical debridement grew multiple organisms, predominantly oral flora, confirming infection of the tracheal stoma tract.
Key takeaways
A tracheostomy stoma can become the source of a polymicrobial soft tissue infection, predominantly with oral flora, presenting as regional swelling, fever, and pain extending from the stoma tract, and should be considered in patients with a tracheostomy who develop new peristomal soft tissue changes, particularly against a background of prior radiation therapy that can impair local tissue healing and defense.
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