title: Retropharyngeal abscess from an unusual organism-Kingella denitrificans-in a patient on low-dose methotrexate.
abstract: Retropharyngeal abscess can be a life-threatening emergency with potential for airway compromise. We report a case of retropharyngeal abscess caused by Kingella denitrificans in a 66-year-old Caucasian man taking low-dose methotrexate for psoriatic arthritis. K denitrificans has not been previously reported as a cause of retropharyngeal abscess. K denitrificans, along with other Kingella species, is often found to be part of the normal upper respiratory tract flora. Potentially life-threatening complications of retropharyngeal abscess can occur in immunocompromised patients. Although complications of immunosuppression are thought to be rare with the use of low-dose pulse methotrexate for non-neoplastic conditions, such complications with prolonged use of low-dose pulse methotrexate may be seen.
authors.affiliation: ENT Department, Doncaster Royal Infirmary, Doncaster, UK.
authors.forename: Divya M
authors.initials: DM
authors.lastname: Rajanna
authors.forename: Jaiganesh
authors.initials: J
authors.lastname: Manickavasagam
authors.forename: Linda
authors.initials: L
authors.lastname: Jewes
authors.forename: Ruth
authors.initials: R
authors.lastname: Capper
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002439:Cefotaxime / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D017881:Kingella; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D016870:Neisseriaceae Infections / Q000188:drug therapy / Q000276:immunology*; D017703:Retropharyngeal Abscess / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D002439:Cefotaxime; D008727:Methotrexate