Nontraumatic retropharyngeal abscess complicated by cervical osteomyelitis and epidural abscess in post-Katrina New Orleans: four cases.
Most retropharyngeal abscesses, including iatrogenic cases, are caused by trauma. Nontraumatic retropharyngeal abscesses usually occur secondary to infection of the retropharyngeal lymph nodes. Because these particular nodes usually disappear by the age of 4 or 5 years, a nontraumatic retropharyngeal abscess in an adult is extremely rare. When they do occur in adults, they are generally seen in immunocompromised patients and in intravenous drug abusers. Left untreated, a retropharyngeal abscess can lead to rare and fatal complications such as cervical osteomyelitis, epidural abscess, and discitis. Retropharyngeal abscesses can be diagnosed with a thorough history of risk factors, an examination for neurologic deficits, and radiologic studies, particularly magnetic resonance imaging. Treatment involves intravenous antibiotic therapy and surgical drainage. During follow-up, it is important to closely monitor the results of clinical neurologic examinations and weekly determinations of the C-reactive protein level and erythrocyte sedimentation rate in order to assess the response to therapy. We report 4 cases of nontraumatic retropharyngeal abscess complicated by cervical osteomyelitis and epidural abscess that were seen in New Orleans within 3 years of Hurricane Katrina, which struck the U.S. Gulf Coast in August 2005.
Faruqui
S
S
Department of Radiology, Tulane University Hospital and Clinic, 1514 Tulane Ave., New Orleans, LA 70112, USA. DrPalacios@aol.com
Palacios
Enrique
E
Friedlander
Paul
P
Melgar
Miguel
M
Alvernia
Jorge
J
Parry
Phillip Vaughan
PV
D000328:Adult; D002574:Cervical Vertebrae; D055867:Cyclonic Storms; D020802:Epidural Abscess / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D055820:New Orleans; D010019:Osteomyelitis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D017703:Retropharyngeal Abscess / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D013203:Staphylococcal Infections / Q000175:diagnosis; D013211:Staphylococcus aureus; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome