Curry, Steven

Dowdall, Jayme

Hassman, Bailey N.

Hewlett, Angela L.

Ryder, Jonathan H

English

University of Nebraska Medical Center Research: DigitalCommons@UNMC

Graduate Medical Education Research Journal Graduate Medical Education Research Journal Volume 3 Issue 1 Article 24 Retro Pharyngeal Abscess and Pott's Disease Due to Tuberculosis: A Case Report Bailey N. Hassman University of Nebraska Medical Center Steven Curry University of Nebraska Medical Center Jonathan H. Ryder University of Nebraska Medical Center Angela L. Hewlett University of Nebraska Medical Center Jayme Dowdall University of Nebraska Medical Center Follow this and additional works at: https://digitalcommons.unmc.edu/gmerj Digital Commons Network Logo  Part of the Higher Education Commons, and the Medicine and Health Sciences Commons Recommended Citation Hassman, B. N., Curry, S., Ryder, J. H., Hewlett, A. L., , Dowdall, J. Retro Pharyngeal Abscess and Pott's Disease Due to Tuberculosis: A Case Report. Graduate Medical Education Research Journal. 2021 Oct 04; 3(1). https://digitalcommons.unmc.edu/gmerj/vol3/iss1/24 This Conference Proceeding is brought to you for free and open access by DigitalCommons@UNMC. It has been accepted for inclusion in Graduate Medical Education Research Journal by an authorized editor of DigitalCommons@UNMC. For more information, please contact digitalcommons@unmc.edu. Retro Pharyngeal Abscess and Pott's Disease Due to Tuberculosis: A Case Report Creative Commons License This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License. This conference proceeding is available in Graduate Medical Education Research Journal: https://digitalcommons.unmc.edu/gmerj/vol3/iss1/24 Sept. 2021  |  Vol. 3  |  Issue 1 Oral Presentations 39*Names in bold type indicate presenting author.Bailey N. Hassman1, 2, Jonathan H. Ryder3, Angela L. Hewlett3, Jayme R. Dowdall21University of Nebraska Medical Center, College of Medicine 2University of Nebraska Medical Center, College of Medicine, Department of Otolaryngology – Head and Neck Surgery 3University of Nebraska Medical Center, College of Medicine, Department of Internal Medicine, Division of Infectious DiseasesMentor: Jayme R. DowdallProgram:SurgeryType: Case ReportBackground: 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 U.S. Chart review on a patient was completed, and the relevant published literature was reviewed.Case: 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 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 clear signs of pulmonary tuberculosis, and the with pulmonary disease. He was treated with rifampin, isoniazid, pyrazinamide, and and linezolid due to concern for possible multidrug resistant TB and transferred to UNMC 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 (Fig. 1 on next page). 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 were discontinued based on susceptibility testing. 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. Just When You Thought You Broke Your FootBen Noble1, T. Jason Meredith11University of Nebraska Medical Center, College of Medicine, Department of Family MedicineMentor: T. Jason MeredithProgram: Family MedicineType: Case ReportBackground: This case report demonstrates a common presentation for an atypical cause of foot pain.Case: A 17 y/o female football player with right foot pain presented to clinic for a second opinion. Three weeks prior, she everted her ankle at practice, experiencing immediate pain, swelling, and ecchymosis in her foot. diagnosed the patient with a “foot fracture.” She was made non-weight bearing for three weeks, then released to return to play without repeat imaging. The mother of the patient and her school’s athletic trainer were concerned with plan and desired a second opinion. At our initial visit, patient was non-weight bearing secondary to pain. She rated her pain at 6/10. Her past medical history was notable for bilateral pes planus and medial tibial stress syndrome. Her exam was remarkable for tenderness over her navicular were obtained that demonstrated no occult navicular fracture, but an accessory navicular bone was noted. Patient was diagnosed with a symptomatic accessory navicular bone. Patient was made non-weight bearing for two weeks then transitioned to weight bearing as tolerated in lace-up ankle brace with initiation of rehab with her school’s athletic trainer. At 4-week follow-up, she was pain free and allowed to return to full participation. Conclusion: Accessory navicular bones often present in young patients with pes planus and lie along the superior medial border of the navicular bone and in close proximity to the tibialis posterior tendon. Painful accessory naviculars often respond well to conservative treatment, including non-weight bearing and fails, referral to orthopedic surgery may be necessary for surgical removal of the accessory navicular bone. Figure 1. CT soft tissue neck with contrast in soft tissue window. Sagittal (A) and axial (B) images show retropharyngeal abscess (arrow) and cervical osteolytic destruction (arrowhead).

Retro Pharyngeal Abscess and Pott\u27s Disease Due to Tuberculosis: A Case Report

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Retro Pharyngeal Abscess and Pott\u27s Disease Due to Tuberculosis: A Case Report

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