Kubo Shigeki, Takimoto Hiroshi, Hosoi Kazuki, Toyota Shingo, Karasawa Jun, Yoshimine Toshiki
Department of Neurosurgery, Osaka Neurological Institute, Toyonaka, Japan.
Neurol Med Chir (Tokyo). 2002 Oct;42(10):447-51. doi: 10.2176/nmc.42.447.
A 52-year-old man complaining of headache and nuchal pain was treated initially under a diagnosis of bacterial meningitis. The meningitis resisted antibiotic therapy, and one week later was complicated by a ruptured retropharyngeal abscess, which led to the correct diagnosis of osteomyelitis of the odontoid process of the axis. His neck was immobilized in a high neck collar and the retropharyngeal abscess was treated by repeated drainage and irrigation. A long course of antibiotic administration finally resolved the infection. Osteomyelitis of the odontoid process is rare and presents with peculiar signs and symptoms. Careful consideration of the differential diagnosis is needed for the early detection of this potentially serious condition.
一名52岁男性，因头痛和颈部疼痛就诊，最初被诊断为细菌性脑膜炎并接受治疗。该脑膜炎对抗生素治疗无效，一周后并发咽后脓肿破裂，从而确诊为枢椎齿突骨髓炎。患者颈部用高领颈托固定，咽后脓肿通过反复引流和冲洗进行治疗。长期使用抗生素最终控制了感染。齿突骨髓炎较为罕见，有独特的体征和症状。对于这种潜在的严重疾病，需要仔细考虑鉴别诊断以实现早期检测。
