Hyperintensity as shown in Figure 2A, emergency cervical MRI was Showed no radiographical abnormalities except comparatively Next morning, he had low grade fever (37.2oC) but had Severe pain in the neck and left shoulder followed by the difficultiesįor extending his neck. History of vertebral surgery or injuries. Without preceded respiratory tract infection. Epidural abscess was disappeared and retropharyngeal space was decreased.Ī 47-year-old man gradually developed neck pain in the evening (C) T2-weighted image 15days after admission. Epidural abscess was observed in C3 to C5 level (large arrow). (B) Gadrinium-enhanced T1-weighted image 7 days after admission. Small arrows indicate the abscess in retropharyngeal space extended from C1 to C5 level. He was discharged at 24ĭays after hospitalization without orthopedic surgery.įigure 1: Sagittal cervical MRI of case 1. Prominent shrinkage of extradural abscess. At 15days after hospitalization, MRI showed Therefore, the antibiotic was changed to another broad spectrumĪntibiotics (PAMP/BP). Patient complained sensory disturbances in his left hand and forearm.Ĭervical MRI showed the extradural (epidural) abscess in C3 andĬ4. On 7 days after the diagnosis, however, the Therefore, a broad spectrumĪntibiotic (MEMP) was administered intravenously.

In adults,Īerobic organisms were also isolated. That anaerobic organisms are predominantly isolated. Previous study has shown that retropharyngeal abscess tends to occur mostly in children and microbiological review of children indicated Culture of the abscess was negative, which mayīe due to the prior administration of antibiotics at other hospital. Puncture of the abscess and drainage was performed immediatelyīy otolaryngologists. Under the diagnosis of retropharyngeal abscess, TheĬervical MRI revealed widening of the prevertebral space along C1 PCRĮxamination for tuberculosis in cerebrospinal fluid was negative. Cerebrospinalįluid examination disclosed pleocytosis (106 leucocytes/mm3,Ĩ2% of lymphocytes) with extremely elevated protein (392 mg/ĭl normal range, 10-40mg/dl) and IgG concentrations (69 mg/ĭl normal range, < 4 mg/dl). BloodĮxamination showed that white blood cell count was 11500 (4000 Other neurological findings were all normal. He had a difficulty to open his mouth and had hoarseness.Īlthough other cranial nerves were not involved, nuchal rigidity Then, he visitedĪnother hospital and was transferred to our hospital. He could not turn his neck in any direction. High fever continued following day and occipital pain got On the nextĭay, he visited a local practice and was prescribed a NSAID andĪntibiotics. Case Presentation Case 1Ī 39-year-old man had fever and occipital pain. Of emergency MRI examination of the spine. Present cases well illustrated the usefulness and diagnostic importance Here, we report two cases, i.e., aĬase of fulminant retropharyngeal abscess and a case of acute pyogenicĬervical spondylitis, both of them showed favorable outcomes. Vertebral surgical history) are very rare but may lead to potentially Keywords: Retropharyngeal abscess Pyogenic cervical spondylitis Deepĭeep neck infectious disorders in healthy adults (without Thus, emergency MRI of cervical spine would offer reliable methods forĭiagnosis and speedy treatments of deep neck inflammatory diseases. I.e., the inflammations were confined to the vertebra without affecting adjacent Spondylitis, we could detect the very early stage of the disease by cervical MRI, Especially in the case of pyogenic cervical Both cases recovered almost fully withoutĪny orthopedic intervention. Magnetic resonance imaging (MRI), we succeeded in making prompt diagnosesĪnd initiate appropriate treatments. With abnormal findings on emergency cervical Pyogenic cervical spondylitis are potentially life-threatening disorders and are Deep neck inflammatory disorders such as retropharyngeal abscess and

Infection of the cervical spine x ray