Abstract
Background: We describe a rare case of Candida albicans retropharyngeal infection with upper cervical spondylodiscitis associated with epidural abscess triggered by ingestion of a chicken bone. Case Description: A 63-year-old woman presented with posterior neck and bilateral shoulders pain three weeks after choking on a 2-centimeter chicken bone. Magnetic resonance imaging (MRI) revealed spondylodiscitis and epidural abscess with significant spinal cord compression at C2 and C3 levels. A Barium swallow showed a focal disruption of the posterior wall of the esophagus. A posterior upper cervical fixation (C2-C5) was initially performed. One week later an anterior decompressive procedure was carried out followed by iliac crest bony fusion, and repair of the esophageal defect. Intra-operative cultures showed heavy growth of Candida albicans. After a transitory post-operative neurologic worsening, and after six weeks of appropriate antifungal therapy, the patient achieved a full clinical and radiologic recovery. Conclusion: Prompt surgical debridement, fusion and stabilization combined with adequate antimicrobial agents are necessary to guarantee a good outcome and reverse the neurological deficits.
Highlights
The majority of foreign bodies are ingested uneventfully via the intestinal tract but around 5% to 10% get stuck in the esophagus possibly leading to grave consequences [1]
We report a rare case of retropharyngeal abscess, spondylodiscitis and epidural abscess with significant spinal cord compression at C2-C3 levels caused by Candida albicans
While candida species are an unusual cause of spinal osteomyelitis, they should be considered in traumatic injuries
Summary
The majority of foreign bodies are ingested uneventfully via the intestinal tract but around 5% to 10% get stuck in the esophagus possibly leading to grave consequences [1]. How to cite this paper: Skaf, G. and Elias, E. Elias comprising only 2% to 7% of all bone conditions [4]. Cervical spondylodiscitis is less common than thoracic and lumbar levels involvement, it can be a much more dramatic and rapidly deteriorating process, leading to early neurological deficits [5]. Bacterial infections especially Staphylococcus aureus remain the most common cause of spondylodiscitis [7]-[11], whereas Candida sp. Are considered rare causative agents [12]. We report a rare case of retropharyngeal abscess, spondylodiscitis and epidural abscess with significant spinal cord compression at C2-C3 levels caused by Candida albicans
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