Retropharyngeal and epidural abscess from a swallowed fish bone

Retropharyngeal abscess is not uncommon, but the incidence of epidural extension of a retropharyngeal abscess is very rare. Intraspinal involvement of the deep neck infection should be suspected if the patient has neurologic deficits. Emergent surgical drainage and aggressive antibiotic treatment are necessary. The outcome is strongly associated with the level of neurologic function at the time of diagnosis. Contrast-enhanced computed tomography is an excellent diagnostic method for any deep neck infection. A case is presented in which a perforating pharyngeal foreign body (fish bone) induced a retropharyngeal and epidural abscess. The literature is reviewed to improve the early recognition and treatment of this complication of deep neck infection.