Clinical diagnosis
Case 2
【Follow-up】
The patient received an open incision, and a tube drainage inserted from the neck into retropharyngeal space and oral medicine of antibiotics for several days. Her symptom dramatically improved and no recurrent inflammation occurred for two months after discharge.
【Discussion】
Retropharyngeal space is usually closed and situated in the back of the throat behind the posterior pharyngeal wall. Retropharyngeal abscess results from a bacterial infection from nasopharynx, oropharynx, tonsils, sinuses and penetrating infection due to a foreign body such as a fish bone (1, 2,3). Retropharyngeal abscess is reported to occur in young children who do not have adequate dental care (1,2).
Meanwhile, spinal epidural abscess is a rare disorder caused by infection in the area of the spine and the membrane covering the spinal cord and it usually occurs in the thoracic or lumbar regions (4,5). An underlying infection is often present (6). Epidural abscess causes paresis, bowel or bladder dysfunction (6). Then, speedy surgical drainage is recommended (4-6). In the present case, retropharyngeal abscess and epidural abscess occurred simultaneously in a middle-aged woman originated from cervical suppurative spondylitis.The tube drainage insertion from the neck and antibiotics brought about effective cure.
【Summary】
A fifty three-year-old female suffering from neck pain with fever came to our hospital.
Enhanced CT depicted simultaneous retropharyngeal abscess and epidural abscess originated from cervical suppurative spondylitis. The tube drainage from the neck and antibiotis led to cure and no recurrence for two months. Although the simultaneous occurrence of retropharyngeal abscess and eridural abscess is rare, it can occur from the suppurative spondylitis.
【References】
1.Wilson CD, et al. Otolaryngol Head Neck Surg. 2016 Mar 1. pii: 0194599816634636. [Epub ahead of print]PMID:26932964
2.Hu X, et al. Spine J. 2015 Oct 22. pii: S1529-9430(15)01528-4. doi:
3.Nakanishi M, et al. Masui. 2015 Aug;64(8):837-40. Japanese. PMID:26442419
4.Reihsaus E, et al. Neurosurg 2000;23:175-204
5.Nussbaum ES, et al. Surg Neurol 1992; 225-231
6.Killen MC, et al. Inr J Spine Surg 2015;9 :47. doi: 10.14444/2047. eCollection 2015.
2016.04.13
COPYRIGHT © SEICHOKAI YUJINKAI. ALL RIGHTS RESERVED.