Prevertebral Abscess Research Articles

Prevertebral thoracic abscess in neonate- a previously unknown cause of respiratory failure in neonates: a case report

A prevertebral abscess is one of the serious infections of the prevertebral space. Prevertebral abscess cases are reported in children and adults. However, it has not been reported in neonates to date, and our team report a case of prevertebral abscess in a 17-day-old baby. A previously healthy term neonate with no antecedent risk factors and an evident source of infection presented with respiratory failure and repeated extubation failures. On evaluation, bronchoscopy revealed antero-posterior collapse of the trachea; further evaluation by computed tomography scan revealed a prevertebral thoracic abscess which was compressing the trachea. Surgical drainage and IV antibiotics led to complete resolution, and the neonate is doing well on follow-up. Prevertebral thoracic abscess is an uncommon cause of airway compression in the neonates. It is important to consider in the differential diagnosis of airway compression.

Odynophagia in individuals with neck pain: the importance of differential diagnosis in physiotherapy practice.

Odynophagia refers to painful swallowing caused by various underlying factors that must be excluded to determine the best treatment approach. Neck pain is a debilitating condition requiring treatment in rehabilitative settings. There are several circumstances in which odynophagia and neck pain coexist, such as tendinitis of the longus colli muscle and paravertebral calcification, prevertebral and retropharyngeal abscess, esophageal perforation, aortic dissection, thyroid cartilage fracture, thyrohyoid ligament syndrome, pneumomediastinum and subcutaneous emphysema, and after physical exercise. Physiotherapists are professionals most likely to encounter individuals with neck pain and provide interventions such as massage, manual therapy, exercise, and electrotherapy. Therefore, it is important to recognize that neck pain can stem from different clinical conditions that require interventions other than physiotherapy. A differential diagnosis is crucial to ensure appropriate referrals for therapeutic interventions.

Common Iliac Artery Mycotic Pseudoaneurysm Associated with a Prevertebral Infection: A Case Report.

Mycotic pseudoaneurysms are rare but severe sequelae of an arterial wall infection. If undiagnosed and untreated they can lead to significant morbidity and mortality through complications such as arterial rupture or dissection. This report details the case of a 64-year-old-male who developed a left common iliac artery mycotic pseudoaneurysm from Proteus mirabilis, which was associated with a prevertebral abscess. The patient presented with isolated, left lower extremity edema and intermittent fevers. The case is unique in both the pathogen (P mirabilis) and in its association with presumed direct arterial wall infection from an adjacent prevertebral abscess. The obscure presentation highlights the need for a high clinical suspicion of such a diagnosis when a patient presents with a certain constellation of symptoms and the right predisposing risk factors in their history.

Fluoroscopy guided transpedicular abscess infusion and drainage in thoracic-lumbar spondylitis with prevertebral abscess.

To evaluate the effectiveness of fluoroscopy guided transpedicular abscess infusion and drainage in thoracic-lumbar spondylitis with prevertebral abscess. We retrospectively reviewed 14 patients with infectious spondylitis with prevertebral abscesses from January 2019 to December 2022. All patients underwent fluoroscopy guided transpedicular abscess infusion and drainage. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), visual analog scale (VAS), Macnab criteria, and magnetic resonance imaging (MRI) were compared before and after the operation to evaluate clinical outcomes. Among the 14 patients with prevertebral abscesses, 64.29% (9/14) involved the lumbar spine and 35.71% (5/14) involved the thoracic spine. The ESR, CRP, and VAS scores decreased from 87.34 ± 9.21, 93.01 ± 11.17, and 8.38 ± 0.97 preoperatively to 12.35 ± 1.61, 8.52 ± 1.19, and 2.02 ± 0.64 at the final follow-up, respectively. MRI at the final follow-up showed the disappearance of the prevertebral abscess compared with that in the preoperative group (66.95 ± 12.63 mm in diameter). Ten patients achieved an "excellent" outcome, while the remaining four patients obtained a "good" outcome according to the Macnab criteria. Fluoroscopy guided transpedicular abscess infusion and drainage is a safe and minimally invasive procedure for the management of thoracic-lumbar spondylitis with a prevertebral abscess.

The First Case of Infectious Spondylitis Caused by Gemella bergeri

Gemella bergeri, a member of the genus Gemella, is a facultatively anaerobic, Gram-positive cocci. G. bergeri is a component of normal oral flora; however, it can become pathogenic and cause infections in patients with poor oral hygiene. A 78-year-old man was admitted to a hospital with a complaint of increasing posterior neck pain and lower back pain for 2 weeks. MRI was suggestive of infectious spondylitis at the C3-C4 level with prevertebral abscess formation, anterior epidural abscess formation. We identified Gemella bergeri in closed pus obtained during the surgery. Herein, we describe the first case of infective spondylitis caused by G. bergeri.

Indications and complications prevention and management of phaseⅡ implantation of Provox Vega voice prosthesis after total laryngectomy

Objective: To explore the indications and management of common postoperative complications of phase II tracheoesophageal puncture (TEP) for Provox Vega voice prosthesis after total laryngectomy. Methods: The clinical data of 20 patients undergoing phase II TEP for Provox Vega voice prosthesis in our hospital between May 2021 and January 2022 were analyzed. Among them, there were 19 males and 1 female, aged from 37 to 76 years, with an average age of (60.0±8.4)years. The surgical indications and the prevention and treatment of common postoperative complications were summarized. Descriptive analysis was used in this research. Results: The basic surgical indications were as following: after total laryngectomy, there was no stenosis of the stoma and esophagus entrance, no scar constitution, no mouth opening restriction, no stiffness and backward restraint of the neck after radiotherapy, and more than half a year apart surgery or radiotherapy. Among the 20 patients, 18 underwent implantation successfuly, 1 failed in the operation, and for 1 patient, the prosthesis was removed due to bleeding 1 week after implantation. The common postoperative complications included TEP fistula infection (2 cases), the TEP fistula bleeding(1 case), deep neck (prevertebral) abscess (1 case), granulation at the inner side of the TEP fistula (1 case), invagination of the prosthesis (2 cases) and leakage around the prosthesis (2 cases). All patients were cured with different interventions. Conclusions: The Provox Vega voice prosthesis is generally safe for phase Ⅱ implantatione, but implantation indications need to be established. Common postoperative complications can be solved through preventive and remedial interventions.

Akutni prevertebralni apsces kao neobičan uzrok bolova u donjem delu leđa - prikaz slučaja

Introduction: Diseases of prevertebral spaces are uncommon but can result in significant morbidity. Case report: This is a case report of acute prevertebral abscess in a 40year-old man. After being transferred to our hospital the patient was initially diagnosed with lower back pain and with high-grade fever. Magnetic resonance imaging (MRI) suggested prevertebral abscess from Th11-L1. Blood test indicated a bacterial inflammation. Antibiotics were administered. The patient's condition consequently improved. He was discharged with normal neurological status and without any symptoms with a complete regression of the abscess on check-up MRI. Discussion: Magnetic resonance imaging remains the gold standard for the radiological demonstration of spine abscess. Antibiotic therapy is a pillar of treatment for spine abscess and should be a part of the treatment in all cases. Conclusion: In conclusion, our aim is to stress the importance of considering a prevertebral abscess in the differential diagnosis in patient with low back pain.

Clinical Problem Solving: A Case of Complicated Staphylococcal Infection

Abstract A 61-year-old male with diabetes mellitus and cervical spondylosis presented with severe neck pain and fever. Magnetic resonance imaging spine showed prevertebral abscess and spondylodiscitis. Blood culture done elsewhere grew Staphylococcus aureus. On further evaluation, Positron emission tomography-computed tomography showed prevertebral collection with air foci within. Differential diagnosis based on possible clinical scenarios is discussed in the case. This case report highlights the importance of accurate identification of susceptibility of Staphylococcal aureus, off label use of joint infection multiplex polymerase chain reaction, targeted antibiotic therapy, timely surgical intervention, and de-escalation to oral therapy.

A Case of Prevertebral Abscess with Lemierre’s Syndrome Which was Difficult to Differentiate from Retropharyngeal Abscess and Calcific Tendinitis of the Longus Colli Muscle

This is a report of a case of prevertebral abscess with Lemierre’s syndrome, which was difficult to differentiate from a retropharyngeal abscess and calcific tendinitis of the longus colli muscle.

Breeching “The Goldilocks Zone”: Tetraplegia as a Rare Life-Altering Infective Complication of Adjuvant Breast Cancer Chemotherapy

Background: Adjuvant chemotherapy has been an integral component of breast cancer care for decades. Advances in supportive care have been made, but despite this, infective complications of therapy remain a significant toxicity concern. Case Presentation: A premenopausal patient presented to the emergency department during the third wave of the Covid-19 pandemic with sepsis after a second course of adjuvant docetaxel-cyclophosphamide chemotherapy. Overnight she developed tetraplegia. An urgent MRI cervical spine revealed a pre-vertebral, vertebral, and epidural abscess. This was treated with an emergency C4-C7 posterior cervical laminectomy and decompression. Her inpatient care involved a protracted ICU admission followed by rehabilitation. She remains tetraplegic and requires continued inpatient care over a year after presentation. Restricted pandemic-related hospital visiting has compounded the impact of her illness. Conclusion: Infective complications of adjuvant breast cancer chemotherapy remain an issue despite advances in supportive care. This case highlights the devastating, life-altering impact that these complications can have as emphasized by the inclusion of the patient’s perspective.

A Case of Deep Neck Infection and Spinal Cord Abscess Related With Acupuncture

A 66-year-old male patient was initially diagnosed with prevertebral and retroperitoneal abscess after cervical acupuncture. The patient underwent cervical incision and drainage, and abdominal percutaneous drainage. During postoperative care, quadriplegia was developed, and an epidural abscess of the spinal cord was identified at the fifth and sixth cervical vertebra. Urgent decompression and drainage for spinal cord abscess was performed. Sixteen weeks after decompression, quadriplegia was improved and the patient was able to walk by himself. We report, along with a literature review, a case of multiple abscesses including spinal cord abscess that developed after a cervical acupuncture.

Retropharyngeal Abscess and Pott’s Disease Due to Tuberculosis: A Case Report

Introduction: Extrapulmonary mycobacterial infection can lead to vertebral spondylitis and osteomyelitis (Pott’s disease). Retropharyngeal abscess with concurrent spinal osteomyelitis is a rare presentation of tuberculosis in the US. Chart review on a patient was completed, and the relevant published literature was reviewed. Case Presentation: A previously healthy 34-year-old male originally from Sudan presented to an outside hospital with a 2-month history of neck pain, sore throat, odynophagia, fevers, and chills. MRI showed a retropharyngeal abscess and suspected cervical spine osteomyelitis. Acid-fast bacillus (AFB) smear was positive from a neck drain specimen, but sputum was negative. Chest imaging did not show findings consistent with pulmonary tuberculosis. He was treated with rifampin, isoniazid, pyrazinamide, and ethambutol (RIPE) along with moxifloxacin and linezolid due to concern for possible multidrug resistant tuberculosis and transferred to our center for further care. Culture isolated Mycobacterium tuberculosis. CT neck showed vertebral tuberculous osteomyelitis (Pott’s disease) of C1-C3 with a multiloculated retropharyngeal and prevertebral abscess (Figure 1). The patient was taken to the OR for posterior spinal fusion from occiput to C4 and transoral incision and drainage of the abscess. The post-operative course was uneventful, and moxifloxacin and linezolid were discontinued when Xpert MTB/RIF test revealed rifampin susceptibility. At follow-up the patient’s symptoms had resolved. Patient consent was obtained to utilize this case for educational purposes. Conclusions: This report presents the multidisciplinary treatment of this patient requiring infection control measures and antibiotic therapy by infectious disease, posterior spine fusion by orthopedic surgery, and retropharyngeal abscess drainage by otolaryngology.

Chronic Sphenoiditis With Deep Neck Space Extension: Case Report With Review of the Literature and Postulated Mechanisms for Extracranial Extension.

Isolated primary sphenoid sinusitis is a rare occurrence, estimated to make up less than 3% of sinus infections. The posterior anatomic location of the sphenoid makes treatment challenging when it becomes infected. Complications involving intracranial extension to surrounding structures often result in cranial nerve deficits due to their proximity. A single case of chronic sphenoiditis with direct extracranial extension into the prevertebral space is reported with a discussion on clinical presentation, diagnosis, and management. A 46-year-old female patient with diffuse headaches radiating into the neck and throat was evaluated in the office. Computed tomography demonstrated sphenoiditis with direct extension into the prevertebral space. Imaging revealed a purported route of direct extension through the clinoid and directly into the clivus to form an abscess in the longus colli muscle. The patient underwent endoscopic surgical management including drainage of the prevertebral abscess and has since made a full recovery. This is the first reported case of direct extension of sphenoiditis into the prevertebral space. The findings highlight the importance of aggressive treatment of chronic sphenoid infections to prevent detrimental complications. Computed tomography imaging proved an advantageous imaging modality to demonstrate bony erosion and sinus tracts from the skull base to the deep neck space.

A challenging diagnosis in a patient with Odynophagia

Tuberculous retropharyngeal abscesses are rare but potentially life-threatening manifestations of tuberculosis. We present herein a case of an 18-year-old male patient, a migrant from Somalia, accusing fever, odynophagia and neck pain. CT scan and MRI study of the neck showed a retropharyngeal and prevertebral abscess from C1 to D1 with the involvement of epidural space and spondylitis. Resolution of the abscess with few signs of residual spondylitis was achieved after surgical evacuation and antitubercular treatment.

Cervical prevertebral abscess with Burkholderia pseudomallei: A report of two cases and review of literature

Cervical prevertebral abscess with Burkholderia pseudomallei: A report of two cases and review of literature

A Refractory Case of Prevertebral Space Abscess in a Patient with Leukemoid Reaction after Treatment with a Tracheoesopharyngeal Shunt

A Refractory Case of Prevertebral Space Abscess in a Patient with Leukemoid Reaction after Treatment with a Tracheoesopharyngeal Shunt

First reported case of vertebral osteomyelitis due to Erysipelothrix rhusiopathiae

We describe a case of acute vertebral osteomyelitis with associated prevertebral abscess due to Erysipelothrix rhusiopathiae in an immunocompetent adult with recent known traumatic inoculation from the barb of a fish.

Prevertebral tubercular abscess diagnosed by endoscopic ultrasound-guided fine needle aspiration

Prevertebral tubercular abscess diagnosed by endoscopic ultrasound-guided fine needle aspiration

Multiple level spondylodiscitis with presacral abscess in spinal brucellosis: a rare presentation

Importance: We report an unusual presentation of spinal brucellosis involving multilevel spondylodiscitis, prevertebral sacral abscess and isolation of Brucella using a low-yield test like blood culture. Timely identification helped in dispensing the appropriate antibiotic regimen.Observation:Detailed history against an endemic background may give clues to diagnosis of brucellosis. A middle aged farmer from rural India with exposure to cattle excreta presented with severe lower backache and asymmetric paraparesis. Examination revealed proximal lower limb weakness, sensory deficits over L1-L2 dermatomes, sensory level at L1 vertebral level and lumbosacral spinal tenderness with paravertebral muscle spasms. MRI spine with contrast showed multi-level infective spondylodiscitis with a prevertebral sacral abscess. Blood culture helped isolate Brucella melitensis after 8 days. Following this the antibiotic regimen was modified to a twelve month triple therapy with rifampicin, doxycycline and double strength cotrimoxazole.Conclusions and Relevance: Longstanding backache with fever in endemic areas should trigger a differential diagnosis of spinal brucellosis. Though newer diagnostic techniques like ELISA, MRI and agglutination tests are being increasingly used, isolation of Brucella on culture media is still a vital investigation. Diagnosis of brucellosis is vital owing to its potential treatability.

Features of Prevertebral Disease in Patients Presenting to a Head and Neck Surgery Clinic with Neck Pain.

Introduction:Untreated prevertebral space infections, which can be overlooked because of connections with surrounding spaces, may lead to spinal epidural accumulations that cause cord compression. The aim of this study was to analyze the epidemiologic and diagnostic features of cases of prevertebral disease encountered by head and neck specialists.Materials and Methods:The study was designed as a retrospective chart review of 11 patients with prevertebral disease who presented to a head and neck surgery specialist for consultation from 2004 to 2010. Epidemiologic characteristics, clinical signs, diagnostic modalities, time to diagnosis, treatment, and final outcome were analyzed.Ethical Approval:This article does not contain any studies with human participants or animals performed by any of the authors.Results:Seven patients were diagnosed with prevertebral abscess, two with prevertebral cellulitis, and two with calcific cervical tendonitis. The most common presenting signs were neck pain (100%), odynophagia (54%), dysphagia (36%), neck rigidity (36%), fever (27%), and back pain (9%). Five patients (45.5%) showed a bulge on the posterior pharyngeal wall. Four patients with prevertebral abscess showed epidural accumulations on magnetic resonance imaging. Patients with prevertebral abscess and cellulitis were treated with surgical drainage or intravenous antibiotics or both while patients with calcific cervical tendonitis were treated with anti-inflammatory and pain medications. Ten patients were cured, and one with multiple comorbidities succumbed to the disease.Conclusion:Clinicians should have a high index of suspicion of prevertebral abscess or cellulitis in patients presenting with neck pain, fever, dysphagia, and limited range of motion of the neck. Head and neck specialists may be the first to encounter and diagnose this highly morbid disease.