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PICTURE: TUBERCULOUS RETROPHARYNGEAL ABSCESS
Díaz-Cerio-Canduela P
Revista de la Sociedad Otorrinolaringológica de Castilla y León, Cantabria y La Rioja , 2011,
Abstract: The case of a patient diagnosed with pulmonary tuberculosis has a large retropharyngeal abscess secondary to cervical Pott's disease. The images show the high level involvement of the retropharyngeal and wear of the cervical vertebral bodies
Retropharyngeal Calcific Tendinitis Mimicking a Retropharyngeal Phlegmon  [PDF]
Nathalie Gabra,Manon Belair,Tareck Ayad
Case Reports in Otolaryngology , 2013, DOI: 10.1155/2013/912628
Abstract: Background. Acute retropharyngeal tendinitis is a little known but not an uncommon condition. It was first described by Hartley in 1964 as an inflammation of the longus colli muscle secondary to calcium crystals deposition on its insertion. The calcifications are mostly located on the oblique portion of the muscle at the level of C1-C2. Methods. We will describe this disease through 4 cases that presented in our institution. Results. The most common symptoms are severe neck pain, odynophagia, and a painful restriction of neck movement. It is associated with mild fever and inflammatory lab findings such as a slight elevation of white blood cell count, erythrocyte sedimentation rate, and C-reactive protein. CT scan is recommended as the first-line imaging modality to establish a diagnosis. Treatments consist of NSAIDs and analgesics to accelerate the healing process. If symptoms are severe, a course of corticosteroids is required. Conclusion. Since the clinical and laboratory findings of this condition and those of a retropharyngeal abscess overlap, it is important to establish the right diagnosis in order to prevent more invasive procedures. A good knowledge of this clinical entity by otolaryngologists would prevent delays in hospital discharge and unnecessary anxiety. 1. Introduction Acute retropharyngeal tendinitis is a rare condition first described by Hartley in 1964 as an acute inflammation of the longus colli muscle secondary to calcium crystals deposition on the insertion of the muscle [1]. It is characterized by an acute onset of severe neck pain, odynophagia, and a painful restriction of neck movement. The presentation of this disease may be similar to more serious conditions such as retropharyngeal abscess, meningitis, cervical myopathy, and traumatic injury. Thus, knowledge of this condition by Otolaryngologists can prevent misdirected medical therapy, unnecessary invasive procedures, undue anxiety, and delays in hospital discharge. We describe herein 4 cases of retropharyngeal calcific tendinitis that presented in our institution. 2. Case 1 A 63-year-old man presented with a 1-week history of sharp neck pain exacerbated by physical effort, odynophagia, and restricted neck movement in all directions. The flexible endoscopic examination revealed a swelling of the posterior wall of the nasopharynx with diffuse erythema. There was no pus or any suspicious lesions. Oropharynx, hypopharynx, and larynx were normal. His laboratory values included slight leukocytosis and an elevated C-reactive protein. On the same day, a cervical radiography and a
Retropharyngeal Calcific Tendonitis Mimics a Retropharyngeal Abscess  [PDF]
Natasha Pollak,Sonya Wexler
Case Reports in Otolaryngology , 2013, DOI: 10.1155/2013/818561
Abstract: Retropharyngeal calcific tendonitis (RCT) is an uncommon, self-limiting condition that is often omitted in the differential diagnosis of a retropharyngeal fluid collection. This condition mimics a retropharyngeal abscess and should be considered when evaluating a fluid collection in the retropharyngeal space. Although calcific tendonitis at other sites has been well described in the medical literature, it appears that this entity has been underreported in the otolaryngology literature where only a few case reports have been identified. Presumably, the actual incidence is higher than the reported incidence, due to lack of familiarity with this disorder. As an otolaryngologist’s scope of practice includes the managements of retropharyngeal lesions, it is important for the otolaryngologist to recognize the presentation of acute RCT and be familiar with appropriate treatment strategies. Retropharyngeal calcific tendonitis presents with neck pain, limitation of neck range of motion and includes inflammation, calcifications, and a sterile effusion within the longus colli muscle. Treatment is medical with nonsteroidal anti-inflammatory medications. RCT does not require surgical treatment, and an accurate diagnosis can prevent unnecessary attempts at operative drainage. In this study, we discuss two cases of RCT, summarize the salient features in diagnosis, including key radiologic features, discuss treatment options, and review the literature. 1. Introduction We present two cases in which the initial presentation was suggestive of a retropharyngeal abscess, but upon further review, both patients were ultimately diagnosed with retropharyngeal calcific tendonitis, an inflammatory, rather than infectious, condition. The purpose of this case series is to raise awareness of retropharyngeal calcific tendonitis (RCT) as an unusual but possibly not rare cause of a retropharyngeal fluid collection, as well as highlight the salient diagnostic features that will allow the surgeon to make the correct diagnosis, avoid unnecessary incision and drainage, and commence effective treatment early in the disease course. It is important to be able to differentiate between retropharyngeal tendonitis and an abscess, as this determines the correct course of treatment. 2. Case Presentation #1 A 37-year-old man presented to the emergency room with a chief complaint of neck pain and sore throat. He first noticed the neck pain 3 days earlier, but did not think much of it. The pain gradually worsened to 10/10 on the 0–10 pain scale. The neck pain was exacerbated by head movement and
Retropharyngeal cold abscess without Pott’s spine
J Singh, H Velankar, D Shinde, N Chordia, S Budhwani
South African Journal of Surgery , 2012,
Abstract: Retropharyngeal abscesses are infections deep in the neck space that can pose an immediate life-threatening emergency, with potential for airway compromise and other catastrophic complications. In adults these abscesses can develop as a result of vertebral pyogenic osteomyelitis, tube rculosis of the spine, or external injuries caused by endoscopes or foreign bodies (e.g. fish bones). Tuberculosis of the retropharyngeal space is one of the rare forms of extrapulmonary tuberculosis. Early diagnosis and treatment are necessary to prevent the serious complications of the disease. We present a case of tuberculous retropharyngeal abscess in an adult woman without tuberculosis of the cervical spine who was managed surgically by aspirating the retropharyngeal abscess transorally, together with antituberculosis treatment.
A case of retropharyngeal abscess with spondylitis causing tetraplegia  [cached]
Takeshi Kusunoki,Shin Ito,Takashi Iizuka,Noritsugu Ono
Clinics and Practice , 2012, DOI: 10.4081/cp.2012.e52
Abstract: We report a case of retropharyngeal abscess with spondylitis causing tetraplegia. At a previous hospital, administration of antibiotics improved the inflammation findings. However, magnetic resonace imaging showed a remaining retropharyngeal abscess. This patient showed a disturbance of consciousness under this therapy. Therefore, he was admitted to our hospital and underwent a drainage operation. At 1 day after this operation, he recovered from the disturbance of consciousness.
RETROPHARYNGEAL ABSCESS DESCRIBED AS A COMPLICATION OF INFECTIOUS MONONUCLEOSIS
Roldán-Fidalgo A,Laguna-Ortega D,Pinilla-Urraca M,Rodríguez-Valiente A
Revista de la Sociedad Otorrinolaringológica de Castilla y León, Cantabria y La Rioja , 2011,
Abstract: We describe a case of retropharyngeal abscess as a complication of infectious mononucleosis.Adolescent patient attended at the emergency department with a progressively growing retropharyngeal and cervical mass that airway obstruction and required surgery under general anesthesia for drainage and control.The diagnosis of infectious mononucleosis was clinical and serological. Computed tomography (CT) allowed us to evaluate the airway and the extent of the process.
Ingestion and Pharyngeal Trauma Causing Secondary Retropharyngeal Abscess in Five Adult Patients
Sudhir B. Sharma,Paul Hong
Case Reports in Emergency Medicine , 2012, DOI: 10.1155/2012/943090
Abstract: Retropharyngeal abscess most commonly occurs in children. When present in adults the clinical features may not be typical, and associated immunosuppression or local trauma can be part of the presentation. We present a case series of five adult patients who developed foreign body ingestion trauma associated retropharyngeal abscess. The unusual pearls of each case, along with their outcomes, are discussed. Pertinent information for the emergency medicine physician regarding retropharyngeal abscess is presented as well.
Anaesthetic management of difficult airway due to retropharyngeal abscess  [cached]
Rao Manjula,Linga Raju Y,Vishwanathan P
Indian Journal of Anaesthesia , 2010,
Abstract: A one-and-half-year old girl weighing 7.5 kg presented with a history of neck swelling, difficulty in swallowing and breathing. She was posted for incision and drainage on an emergency basis. Diagnosis was confirmed by neck X-ray and computed tomography scan as retropharyngeal abscess. Here we present the successful anaesthetic management of this child at JSS Medical College Hospital, Mysore.
Late evolution retropharyngeal abscess after ingestion of foreign body  [cached]
Ramos, Henrique Faria,Takahashi, Marystella Tomoe,Monteiro, Tatiana Alves,Koishi, Henry Ugadin
International Archives of Otorhinolaryngology , 2009,
Abstract: Introduction: The complications relating to the ingestion of foreign bodies, such as retropharyngeal abscess, are of low prevalence, but potentially severe. Objective: To present one case of late evolution retropharyngeal abscess after ingestion of foreign body. Case Report: Female patient presenting with dysphagia, pain upon cervical motion and sensation of foreign body in the pharynx, about one month after removal of foreign body from the level of the cricopharyngeal muscle. In spite of not having fever or leukocytosis, due to the slight difficulty for cervical move and loss of the laryngeal crepitation, simple radiography and computed tomography were carried out in the neck, which showed signs of retropharyngeal abscess. Surgical draining of the abscess and antibiotic therapy led to good evolution of the case and symptoms reversion. Conclusion: The retropharyngeal abscess may occur during several weeks after ingestion of a foreign body. The absence of fever and leukocytosis does not exclude the diagnosis even in immunocompetent patients. A high degree of suspicion leads to the performance of diagnostic exams and suitable procedures.
Insidious Onset of Tetraparesis due to Cervical Epidural Abscess from Enterococcus faecalis  [cached]
Konstantinos Chr. Soultanis,Vasileios I. Sakellariou,Konstantinos A. Starantzis,Nikolaos A. Stavropoulos
Case Reports in Medicine , 2013, DOI: 10.1155/2013/513920
Abstract:
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