A Case of Spinal Epidural Abscess Associated with Retropharyngeal Abscess

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  • Fujiyoshi Tatsuya
    Department of Otorhinolaiyngology, University of Occupational and Envlronmental Health, School of Medicine
  • Goto Kyoya
    Department of Otorhinolaiyngology, University of Occupational and Envlronmental Health, School of Medicine
  • Shiomori Teruo
    Department of Otorhinolaiyngology, University of Occupational and Envlronmental Health, School of Medicine
  • Udaka Tsuyoshi
    Department of Otorhinolaiyngology, University of Occupational and Envlronmental Health, School of Medicine
  • Sakabe Akiko
    Department of Otorhinolaiyngology, University of Occupational and Envlronmental Health, School of Medicine
  • Tanabe Tadao
    Unit of Central Clinical Laboratory, University Hospital, University of Occupational and Environmental Health
  • Makishima Kazumi
    Department of Otorhinolaiyngology, University of Occupational and Envlronmental Health, School of Medicine

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Other Title
  • 咽後膿瘍が脊髄硬膜外膿瘍へと進展した1例

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Description

Spinal epidural abscesses are known to occur associated with retropharyngeal abscess, but such cases are few in the Literature. We treated a 72-year-old woman who reported pain in the back of the neck. Computed tomography (CT) showed a retropharyngeal abscess extending to the upper neck through the carotid space on the left side and an magnetic resonance imaging (MRI) showed a spinal epidural abscess without cervical vertebral osteomyelitis. The abscess was assumed to reach the epidural space along the nerve root through the intervertebral foramen. Since tonsillitis appeared to cause the retropharyngeal abscess, we performed tonsillectomy, and then drained pus through the superior constrictor musckle, effecting a subsequent cure. Staphyloroccus aureus was recovered from both the pus and tonsil, and Streptococcus constellatus, a member of the Streptococcus milleri group, from the tonsil. Based on a review of the literature, clinical courses of spinal epidural abscess associated with retropharyngeal abscess are not always simple, as 4 of the 7 cases found demonstrated poor prognosis. Spinal epidural abscess should be considered a critical complication of retropharyngeal abscess.

Journal

  • Nippon Jibiinkoka Gakkai Kaiho

    Nippon Jibiinkoka Gakkai Kaiho 105 (11), 1143-1146, 2002

    Japanese Society of Otorhinolaryngology-Head and neck surgery

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