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[Cold parapharyngeal abscess in spondylodiscitis]
H Kooli1, M Marreckchi, M Tiss
1Service ORL, EPS Charles Nicolle, Bvd 9 avril 1936, 1006 Tunis, Tunisie. koolih@excite.com
Background:
The principle danger of pharyngeal abscess is the risk of rupture overflow into the upper respiratory track. Pyogenic abscesses are the most frequent and tuberculosis is rare. We report two cases of retro and parapharyngeal abscesses with tuberculous spondylodiscitis.
Case Reports:
The first case occurred in a 54-year-old woman, the second in a 19-year-old man. Both had a laterocervical swelling associated with a oropharyneal bulge that progressed over several months. Computed tomography showed abscess formation and spinal disease in both cases. Drainage of the abscess led to the distological diagnosis of tuberculosis. Medical management was successful with resolution of the abscess and spinal lesions.
Discussion:
Spinal tuberculosis should be suspected in patients with a parapharyngeal abscess without detectable portal that progresses slowly. A biopsy specimen is required for diagnosis. Magnetic resonance imaging can provide early evidence of spondylodiscities. Medical treatment is indicated.
Insights
Tuberculosis is a rare cause of parapharyngeal abscesses. Early diagnosis of spinal tuberculosis is crucial for successful treatment of these rare but serious infections.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Spinal Surgery
Background:
- Pharyngeal abscesses pose a significant risk of airway compromise due to potential rupture.
- While pyogenic infections are common causes, tuberculosis is a rare etiology.
- This report details two cases of parapharyngeal abscesses associated with tuberculous spondylodiscitis.
Observation:
- Two patients, a 54-year-old woman and a 19-year-old man, presented with slowly progressing laterocervical and oropharyngeal swelling.
- Computed tomography revealed abscess formation and concurrent spinal disease in both individuals.
- Histopathological examination of abscess drainage confirmed tuberculosis.
Findings:
- Tuberculous spondylodiscitis can manifest as a parapharyngeal abscess.
- Prompt diagnosis through biopsy and advanced imaging (MRI) is essential.
- Successful management involves appropriate medical treatment.
Implications:
- Clinicians should consider spinal tuberculosis in patients with unexplained, slowly progressing parapharyngeal abscesses.
- Magnetic resonance imaging aids in early detection of spondylodiscitis.
- Effective medical therapy can lead to resolution of both abscess and spinal lesions.