Pyogenic cervical osteomyelitis presenting as a massive prevertebral abscess in a patient with rheumatoid arthritis.
Pre-existing rheumatoid arthritis appeared to have masked the diagnosis and contributed to a succession of hazardous events in a 58-year-old man with pyogenic cervical osteomyelitis. A massive prevertebral abscess and near asphyxiation finally led to the diagnosis of an indolent Staphylococcus aureus infection in a course marked by antecedent staphylococcal sepsis, a series of dangerous cervical spine chiropractic manipulations in the presence of advanced bony destruction, and, ultimately, cervical spine bony collapse and gibbus formation. The absence of myelopathy despite long-standing progressive advanced destruction is noteworthy. The roentgenologic documentation of this progression was unique. This appears to be the first fully documented case of cervical spine osteomyelitis presenting as a prevertebral abscess in a patient with rheumatoid arthritis.
McGrath
H
H
Department of Medicine, Louisiana State University School of Medicine, New Orleans.
McCormick
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C
Carey
M E
ME
D000038:Abscess / Q000209:etiology*; D001172:Arthritis, Rheumatoid / Q000150:complications*; D002574:Cervical Vertebrae; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis* / Q000209:etiology; D010608:Pharyngeal Diseases / Q000209:etiology*; D013203:Staphylococcal Infections / Q000175:diagnosis*