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A case of cervical Pott’s disease revealed by parapharyngeal abscess

Summary Introduction: We report a case of cervical Pott’s disease revealed by parapharyngeal abscess. Case report: A seven-year-old boy was admitted with a three-week history of painful fluctuating left lateral cervical swelling, associated with night sweats. Examination found trismus, through which a lateral pharyngeal bulge could be observed. Incision and drainage of the abscess on a combined cervical-oropharyngeal approach was performed under general anesthesia, associated to non-specific antibiotherapy by parenteral route. Bacteriology was negative. After one week of antibiotherapy, fever persisted with onset of torticollis. A diagnosis of tuberculosis was considered. Tuberculin skin test was positive at 16.5mm. A second sample by pharyngeal aspiration showed caseous pus with acid-fast bacilli. Cervical spine CT found a retrostyloid abscess with atlantoaxial lysis. Cervical Pott’s disease complicated by Grisel syndrome was diagnosed. Antituberculosis therapy was initiated. Results at five months’ follow-up were satisfactory. Discussion/Conclusion: Parapharyngeal abscess with an etiology of Pott’s disease is rare. Modern imaging is highly contributive to diagnosis and follow-up of lesion regression under treatment.

Auteur(s) : Diom ES, Ndiaye C, Djafarou AB, Ndiaye IC, Faye PM, Tall A, Ndiaye M, Diallo BK, Diouf R, Diop EM.
Pages : 169- 172
Année de publication : 2011
Revue : Annales Françaises d’Oto-Rhino-Laryngologie et de pathologie cervico-faciale. 2011; 128, 3:169-172
N° de volume : 3, 128
Type : Article
Mise en ligne par : TALL Abdourahmane