Acute cervical osteomyelitis and prevertebral abscess after routine tonsillectomy.
BACKGROUND
Tonsillectomy is among the most commonly performed surgical procedures. The development of severe infection after tonsillectomy is a very rare but potentially fatal complication that has not been described in the orthopedic, neurosurgical, or spine literature.


OBJECTIVE
To present acute cervical osteomyelitis and prevertebral abscess formation as a complication of a routine tonsillectomy.


METHODS
Case report, literature review.


METHODS
A case report was prepared on the clinical and radiographic data of a patient presenting with prevertebral abscess and acute cervical osteomyelitis 6 weeks after routine tonsillectomy. A review of relevant literature was additionally performed.


RESULTS
The patient presented 6 weeks after tonsillectomy with evidence of a deep cervical infection. Operative debridement with anterior and posterior surgical stabilization was performed. The patient completed a 6-week course of intravenous antibiotics. At 24-month follow-up, the patient showed no signs of infection and demonstrated a stable fusion mass.


CONCLUSIONS
The development of prevertebral abscess and acute cervical osteomyelitis has been discussed in a small number of otolaryngology case reports and has not been previously reported in the orthopedic, neurosurgical, or spine literature. Symptoms may be nonspecific, and so a high index of clinical suspicion is needed. Delay in treatment may lead to significant morbidity and even mortality. Successful treatment can be obtained through operative debridement and intravenous antibiotic therapy.
Patel
Alpesh A
AA
Department of Orthopaedic Surgery, University of Utah School of Medicine, Salt Lake City, UT 84108, USA. alpesh2@gmail.com
Madigan
Luke
L
Poelstra
Kornelis A
KA
Whang
Peter G
PG
Vaccaro
Alexander R
AR
Harrop
James S
JS
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002574:Cervical Vertebrae / Q000473:pathology; D020802:Epidural Abscess / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010019:Osteomyelitis / Q000209:etiology* / Q000628:therapy; D011183:Postoperative Complications / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D013123:Spinal Fusion; D013290:Streptococcal Infections / Q000209:etiology / Q000628:therapy; D014057:Tomography, X-Ray Computed; D014068:Tonsillectomy / Q000009:adverse effects*; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D014640:Vancomycin