Retropharyngeal Abscess Complicated with Torticollis: Case Report and Review of the Literature

Abstract

Abscess Complicated with Torticollis:Case Report and Review of the Literature. Tohoku J. Exp. Med., 2007, 213 (1), [99][100][101][102][103][104] Retropharyngeal abscess commonly develops among infants and small children, and is associated with the severe inflammation of the retropharyngeal lymph nodes located in the retropharyngeal space. Retropharyngeal abscess causes cervical pain, swelling, contracture of the neck, and in rare cases inflammatory torticollis, all of which result from an inflammatory process that irritates the cervical muscles, nerves or vertebrae. Here we report a rare case of retropharyngeal abscess with a complication of torticollis. A 4-yearold girl suffered from severe retropharyngeal abscess spreading through the deep cervical fascia, as judged by magnetic resonance imaging of the neck. Blood analysis showed high degree of inflammatory reactions, and so the patient was transferred to our hospital ward. The inflammation caused spasms of the prevertebral muscles, eventually leading to torticollis. The surgical drainage was performed immediately under general anesthesia, and an anti-inflammation therapy with intravenously administered meropenem trihydrate and clindamycin was used together with traction therapy to relieve the symptoms of the patient. We must be careful about the existence of epidural abscess and infectious spondylitis when the retropharyngeal abscess causes torticollis. In conclusion, an anti-inflammation therapy using antibiotics, along with traction therapy, was effective to relieve the symptoms. In addition to repeated clinical examinations, cooperation with orthopedists and careful follow-up are necessary. We also discussed the relationship between acute torticollis and retropharyngeal abscess. retropharyngeal abscess; torticollis; danger space; deep neck fascia; traction therapy

A nine month old child with retropharyngeal abscess secondary to mastoid abscess presenting as torticollis: a case report

“…Indeed, a recently published report described a rare case of retropharyngeal abscess complicated by torticollis in a 4-year-old girl [6]. The presenting symptoms of torticollis and the bulging of the posterior pharyngeal wall in our patient were consistent with clinical features found in an earlier series of children with retropharyngeal abscesses [3].…”

Late presentation of torticollis after mastoidectomyforacute mastoiditis

“…23 The most common mechanism by which a mastoid abscess gives rise to a retropharyngeal abscess involves erosion of the mastoid tip, along with the tracking of pus through the sheath of either the digastric muscle or the sternocleidomastoid muscle into retropharyngeal space through the parapharyngeal space. 24 However, the case described in this paper occurred 4 months after surgery for mastoiditis, with no evidence of ongoing infection.…”

Kicked to touch: Hoodwinked by torticollis

“…Of these conditions, retropharyngeal abscess is considered life threatening 7. Retropharyngeal abscess occurs most commonly in the 2–4 years old population8 and is associated with severe inflammation of the retropharyngeal lymph nodes (located in the retropharyngeal space) 9. Clinical findings suggestive of retropharyngeal abscess include fever, irritability, dysphagia, drooling, odynophagia and respiratory distress 8…”