Spontaneous, Non-Traumatic Retropharyngeal Abscess Complicated by Spinal Osteomyelitis and Epidural Abscess in Immunocompetent Adult: Management and Proposal Pathophysiological Mechanism
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Spontaneous, Non-Traumatic Retropharyngeal Abscess Complicated by Spinal
Osteomyelitis and Epidural Abscess in Immunocompetent Adult: Management
and Proposal Pathophysiological Mechanism
Sideris, Giorgos
Nikolopoulos, Thomas
Papadimitriou, Nikolaos
Retropharyngeal abscess (RPA) in adults is a potentially
life-threatening condition that relates in most of the cases with local
trauma. Non-traumatic RPA complicated by spinal osteomyelitis and
epidural abscess is a rare entity in immunocompetent adults and
represents an emergency medical condition when the patient develops
neurologic symptoms. This article presents a case of non-traumatic RPA
complicated by spinal osteomyelitis and epidural abscess in a
77-year-old male with the free past medical history. We highlight the
importance of early and meticulous daily drainage as well as sequential
MRI scanning for early diagnosis, treatment and follow-up for signs of
vertebral involvement. The patient had a full recovery and was
subsequently discharged with per os four-month antibiotic treatment. The
definitive mechanism is unclear for non-traumatic cases with
“hematogenous path” being the closest description. Spontaneous RPA
can develop from bacteria infection spread of adjacent structures, local
inflammatory process and microthrombosis formation can impair the blood
supply of vertebral and intervertebral disks.
(EN)
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