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• W4236120114 abstract "Advances in antibiotic therapy have reduced the incidence of retropharyngeal abscesses. However, the morbidity and mortality rate are high in immune-compromised patients or when diagnosis and treatment are delayed. In the present report, we describe a rare case of a retropharyngeal abscess associated with pyogenic cervical osteomyelitis and a spinal epidural abscess. An 83-year-old man presented to the emergency department of our hospital with disorder of consciousness (Japan coma scale I-2), weakness of the limbs, and a 4-day history of neck pain. Laboratory blood tests revealed a high white blood cell count and C-reactive protein level, and marked hyperglycemia. Thereafter, he was admitted to the internal medicine department with a diagnosis of hyperosmolar hyperglycemia syndrome and a bacterial infection of an unidentified focus. Cerebrospinal fluid examination performed on hospital day 2 indicated aseptic meningitis. Computed tomography performed on hospital day 3 showed a retropharyngeal abscess, after which he was referred to our otolaryngology department. Posterior pharyngeal wall swelling and airway obstruction were observed. Therefore, we performed an emergency tracheotomy and trans-oral incision and drainage of the retropharyngeal abscess. Blood, urine, and pus cultures indicated positive results for Group B Streptococcus. Magnetic resonance imaging performed on hospital day 6 demonstrated pyogenic osteomyelitis and a spinal epidural abscess. We continued conservative antibiotic therapy after consultation with the orthopedics department. However, upper limbs paralysis was noted on hospital day 17. The patient was diagnosed as having myelopathy and an epidural abscess, and he underwent an emergency laminectomy (C2–6). After the surgery, the upper limb paralysis improved. Based on the literature and our experience, we believe that although rare, spinal epidural abscesses are a critical complication that could result in a severe decline in neurologic function or death if diagnosis and treatment are delayed." @default.
• W4236120114 created "2022-05-12" @default.
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• W4236120114 date "2015-01-01" @default.
• W4236120114 modified "2023-10-16" @default.
• W4236120114 title "A Case of a Retropharyngeal Abscess Associated with Pyogenic Cervical Osteomyelitis and a Spinal Epidural Abscess" @default.
• W4236120114 doi "https://doi.org/10.5631/jibirin.108.133" @default.
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