• Yishu Teng, Shuling Huang, Guowei Chen, Zhixiong Xian, Saihong Han, and Lan Li.
• Department of Otolaryngology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China.
• Medicine (Baltimore). 2019 Nov 1; 98 (44): e17784e17784.

RationaleCongenital pyriform sinus fistula (CPSF) is a branchial abnormality originating from the third or fourth branchial pouch and is an important cause of anterior cervical abscess in children. Here we present a case of neck abscess in a newborn that was diagnosed as CPSF.Patient ConcernsA male infant with a birth weight of 3660 g was admitted to hospital 25 minutes after birth after discovery of a cystic mass with extensive skin swelling in the left side of the neck. B-mode ultrasonography of the left neck showed an anterior cervical cystic mass of indeterminate nature.DiagnosisCongenital pyriform sinus fistula.InterventionsThe neck abscess was incised and drained under general anesthesia. Examination under suspension laryngoscopy revealed a pyriform sinus fistula. Laser cauterization was performed simultaneously. The wound was dressed and anti-inflammatory treatment was provided.OutcomesThe neck wound healed uneventfully. After 3 months, the fistula was confirmed to be closed by laryngoscopy under general anesthesia. No recurrence was detected during 9 months of follow-up.LessonsCPSF should be strongly suspected in a patient with an unexplained neck abscess or recurrent acute suppurative thyroiditis, especially on the left side.

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