Large Retropharyngeal Abscess Associated with Cervical Spine Tuberculosis

Abstract

The authors report a case of a 25-year-old man who presented with the history of neck pain and weakness of the right hand of 6-month duration. He had history of fever with evening rise in temperature, loss of weight, and cough. Radiologic investigations of the cervical spine showed collapse of the C5 vertebral body and partial destruction of the C4 and C6 vertebral bodies with kyphotic deformity and a large retropharyngeal hyperintense collection. The patient underwent drainage of the abscess, and the histopathology was suggestive of tuberculosis. He was started on antitubercular treatment and doing well at follow-up.

Keywords

abscess - tuberculosis - retropharyngeal abscesses - Pott's spine

• References

• 1 Singh J, Velankar H, Shinde D, Chordia N, Budhwani S. Retropharyngeal cold abscess without Pott's spine. S Afr J Surg 2012; 50 (04) 137-139
• 2 Ogah OS, Owolabi MO, Akisanya CO. Cervical spine tuberculosis and retropharyngeal abscess in an adult Nigerian. Ann Trop Med Public Health 2012; 5: 587
• 3 Lafitte F, Martin-Duverneuil N, Brunet E. et al. Rhinopharynx et espaces profonds de la face: anatomie et applications à la pathologie. J Neuroradiol 1997; 24 (02) 98-107
• 4 Melchor DíazMA, Domingo CarrascoC, Monge JodráR, Mariño EspuelasJ, Ontañon MartínM. [Tuberculous retropharyngeal abscess in an HIV patient. Report of a case] [in Spanish]. Acta Otorrinolaringol Esp 1993; 44 (06) 467-470
• 5 Fernandez-Ponjoan E. Practical considerations from the study of one thousand patients with tuberculosis of the upper respiratory tract. Vida Nueva 1943; 51: 146-154
• 6 Marques PM, Spratley JEF, Leal LMM, Cardoso E, Santos M. Parapharyngeal abscess in children: five year retrospective study. Rev Bras Otorrinolaringol (Engl Ed) 2009; 75: 826-830
• 7 Saifi M, Kamal M, Singh MK. Tubercular prevertebral and epidural abscess presenting as stridor and dysphagia in an infant: a rare presentation of tuberculosis in infancy. Indian Journal of Case Reports. 2016: 2
• 8 Leibert E, Haralambou G. Spinal tuberculosis. In: Tuberculosis. Philadelphia, PA: Lippincott Williams & Wilkins; 2004: 565-577
• 9 Garg A, Wadhera R, Gulati SP, Kishore D, Singh J. Giant retropharyngeal abscess secondary to tubercular spondylitis. Indian J Tuberc 2009; 56: 225-228
• 10 Bhargava SK, Gupta S. Large retropharyngeal cold abscess in an adult with respiratory distress. J Laryngol Otol 1990; 104 (02) 157-158
• 11 Janssens JP, de Haller R. Spinal tuberculosis in a developed country. A review of 26 cases with special emphasis on abscesses and neurologic complications. Clin Orthop Relat Res 1990; (257) 67-75
• 12 Al Soub H. Retropharyngeal abscess associated with tuberculosis of the cervical spine. Tuber Lung Dis 1996; 77 (06) 563-565
• 13 Gorse GJ, Pais MJ, Kusske JA, Cesario TC. Tuberculous spondylitis. A report of six cases and a review of the literature. Medicine (Baltimore) 1983; 62 (03) 178-193
• 14 Moore SL, Rafii M. Imaging of musculoskeletal and spinal tuberculosis. Radiol Clin North Am 2001; 39 (02) 329-342
• 15 Krishnan A, Patkar D, Patankar T. et al. Craniovertebral junction tuberculosis: a review of 29 cases. J Comput Assist Tomogr 2001; 25 (02) 171-176
• 16 Bank DE, Krug SE. New approaches to upper airway disease. Emerg Med Clin North Am 1995; 13 (02) 473-487
• 17 Duncan NO. Infections of the airway in children. In: Cummings CW, Flint PW, Haughey BH. et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed.. Philadelphia, PA: Elsevier Mosby; 2010
• 18 Hoffman EB, Crosier JH, Cremin BJ. Imaging in children with spinal tuberculosis. A comparison of radiography, computed tomography and magnetic resonance imaging. J Bone Joint Surg Br 1993; 75 (02) 233-239
• 19 Vieira F, Allen SM, Stocks RMS, Thompson JW. Deep neck infection. Otolaryngol Clin North Am 2008; 41 (03) 459-483 vii