Retropharyngeal Abscess Secondary to Rare Posttraumatic Spondylodiscitis: An Unusual Presentation

Abstract

Introduction: Posttraumatic spondylodiscitis is an uncommon but serious complication of spinal trauma. It may lead to severe neurological impairment and systemic infection. Retropharyngeal abscess (RPA), typically associated with upper respiratory infections, is rarely reported as a complication of nontuberculous spondylodiscitis, especially in the context of cervical trauma. This rare association poses a dual threat: airway obstruction and spinal cord compression. Our work aimed to report a rare case of posttraumatic, nontuberculous cervical spondylodiscitis complicated by an RPA, leading to both respiratory and neurological compromise, and to highlight the importance of early multidisciplinary management.

Observation: We present the case of a 45- year-old male with posttraumatic dorsal and cervical spondylitis following a road traffic accident. He developed progressive paraplegia and respiratory distress. Imaging revealed multilevel vertebral involvement with spinal cord compression and an RPA. The first transoral drainage was ineffective, and the recurrence within 48 hours necessitated a second external surgical approach. Cultures identified methicillin-resistant Staphylococcus aureus and Klebsiella pneumoniae. Broad-spectrum antibiotics and intensive care management led to gradual improvement.

Conclusion: This case underlines the complexity and severity of posttraumatic spondylodiscitis with RPA. Prompt diagnosis and a multidisciplinary therapeutic strategy are vital to prevent life-threatening complications and improve patient outcomes.

Keywords: methicillin-resistant Staphylococcus aureus; multidisciplinary care team; retropharyngeal abscess; spinal cord compression; spondylodiscitis.