A Rare Cause of Retropharyngeal Abscess: Cervical Pott's Disease

A 6-year-old boy presented with 4 months of right neck pain that, along with increasing swelling over the previous 15 days, was associated with fever, night sweats, and dysphagia. Physical examination showed diffuse right neck swelling (Figure 1A). Serological tests for human immunodeficiency virus (HIV) were negative. A lateral cervical spine X-ray revealed widening of the retropharyngeal space (Figure 1B). Magnetic resonance imaging (MRI) revealed a hyperintense pre-vertebral collection (Figure 1C). A percutaneous fineneedle aspiration decompressed the collection. Microscopic examination of the material obtained showed acid fast bacilli and granulomatous inflammation (Figure 1D). Administration of antituberculous drugs (isoniazid, rifampicin, and pyrazinamide) led to rapid improvement (disappearance of visible swelling at 4 weeks), especially the ability to eat normally. Six months of treatment was completed. Retropharyngeal abscess caused by cervical Pott’s Disease is rare and should be suspected with a destructive spine lesion with associated findings in the appropriate setting.