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Tubercular retropharyngeal abscess in early childhood
1Department of Ear, Nose and Throat, Lady Hardinge Medical College, New Delhi, India.
Insights
Pott's disease, a rare spinal infection, can affect young children, causing severe respiratory distress and neurological issues. Prompt surgical drainage and anti-tubercular therapy led to recovery in two pediatric cases.
Area of Science:
- Pediatric infectious diseases
- Spinal tuberculosis
- Neurosurgery
Background:
- Pott's disease (tuberculosis of the spine) typically affects adults.
- Retro-pharyngeal abscesses in the cervical spine are rare, especially in young children.
- This condition can lead to life-threatening complications like respiratory distress and neurological deficits.
Observation:
- Two pediatric cases of Pott's lower cervical spine with retro-pharyngeal abscess are presented.
- Both children exhibited severe respiratory distress.
- One child presented with paraparesis, indicating neurological compromise.
Findings:
- External drainage of the retro-pharyngeal abscess was performed without anterior cervical fusion.
- This surgical approach, combined with conventional anti-tubercular therapy, resulted in prompt recovery for both patients.
- The cases highlight the possibility of Pott's disease presenting at a very young age.
Implications:
- Early recognition and prompt surgical intervention are crucial for managing pediatric Pott's disease with retro-pharyngeal abscess.
- External abscess drainage may be sufficient, avoiding more invasive procedures like anterior cervical fusion in select cases.
- These findings expand the understanding of atypical presentations of spinal tuberculosis in children.
Abstract:
We present two cases of Pott's lower cervical spine with retro-pharyngeal abscess presenting at an unusually young age. These children presented with a life threatening respiratory distress; one of them had neurological deficit in the form of paraparesis. External drainage of abscess without anterior cervical fusion was adequate as a surgical measure for their prompt recovery while these cases were on conventional anti-tubercular therapy.