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成人咽后脓肿的一种罕见病因:颈椎化脓性脊椎间盘炎。

An uncommon cause of retropharyngeal abscess in adults: Cervical pyogenic spondylodiscitis.

作者信息

Bouatay R, Belhadj Miled H, Koubaa Jamel

机构信息

ENT department at Fattouma Bourguiba hospital in Monastir, Tunisia; University of Monastir, Tunisia.

ENT department at Fattouma Bourguiba hospital in Monastir, Tunisia.

出版信息

Int J Surg Case Rep. 2024 Oct;123:110197. doi: 10.1016/j.ijscr.2024.110197. Epub 2024 Aug 20.

Abstract

INTRODUCTION AND IMPORTANCE

Retropharyngeal abscess (RPA) represents a rare and life-threatening condition, particularly uncommon in the adult population. The simultaneous occurrence of RPA, and cervical spondylodiscitis is an exceedingly infrequent situation.

CASE PRESENTATION

we reported the case of a 67-year-old male who presented to our department with complaints of sore throat, restricted neck range of motion, as well as numbness and weakness in the right arm persisting for two weeks. Cervical computed tomography identified a retropharyngeal abscess measuring 15 cm in height around C3 to D3. Subsequent cervical magnetic resonance imaging disclosed revealed infectious spondylodiscitis at C5-C6-C7 and partially collected epiduritis from C5 to C7. The abscess was promptly drained by the transoral way. Following the procedures, the patient was discharged with a cervical collar and a prescribed course of antibiotics.

CLINICAL DISCUSSION

Cervical retropharyngeal abscesses complicating spondylodiscitis is very rare. The clinical symptoms are variable and nonspecific. Given the potentially life-threatening nature of this condition, its management represents a real challenge.

CONCLUSION

The management of such complex cases necessitates a multidisciplinary approach involving otolaryngologists, neurosurgeons, and infectious disease specialists to mitigate the risk of complications and prevent any potential delays in treatment.

摘要

引言与重要性

咽后脓肿(RPA)是一种罕见且危及生命的疾病,在成人中尤为少见。RPA与颈椎间盘炎同时发生的情况极为罕见。

病例报告

我们报告了一例67岁男性患者,他因咽痛、颈部活动受限以及右臂麻木和无力持续两周前来我院就诊。颈椎计算机断层扫描发现C3至D3水平有一个高15厘米的咽后脓肿。随后的颈椎磁共振成像显示C5 - C6 - C7存在感染性椎间盘炎,并从C5至C7有部分硬脊膜外炎。脓肿通过经口途径迅速引流。术后,患者佩戴颈托并按规定疗程服用抗生素出院。

临床讨论

颈椎间盘炎并发咽后脓肿非常罕见。临床症状多样且无特异性。鉴于这种疾病潜在的危及生命的性质,其治疗是一项真正的挑战。

结论

对于此类复杂病例的治疗需要多学科方法,包括耳鼻喉科医生、神经外科医生和传染病专家,以降低并发症风险并防止治疗出现任何潜在延误。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7924/11387685/81a0a6e4ee62/gr1.jpg

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