Cervical spondylodiskitis revealed by retropharyngeal abscess

INTRODUCTION: Spondylodiskitis is rare in the cervical vertebrae. We report a case of cervical spondylodiskitis revealed by a retropharyngeal abscess caused by a pyogen agent. The aim of our work was to shed light on the diagnosis and therapeutic difficulties of spondylodiskitis associated with a retropharyngeal abscess. CASE REPORT: A 70-year-old patient was admitted to the emergency department for a progressive laryngeal dyspnoea of 3 months duration. Clinical examination showed severe dyspnoea. Oropharynx and pulmonary exams were unremarkable. Failure of medical treatment led to the performance of an emergency tracheotomy after which the patient developed a flaccid quadriparesis. Medullar MRI revealed a spondylodiskitis with medullary compression and a retropharyngeal abscess. Surgical biopsy concluded to a pyogen osteitis. Treatment in the form of antibiotics and cervical immobilisation was instituted. Evolution was marked with septicaemia, multiple organ failure and ionic disturbance leading to death. COMMENTS: Cervical spondylodiskitis is rare. Its revelation by retropharyngeal abscess is also rare. MRI is the tool of choice for diagnosing discovertebral infections and its prevertebral extensions. Treatment is medical and surgical.