Tuberculous retropharyngeal abscess with posterior mediastinal extension and quadriplegia in a 13-year-old Nigerian girl

Abstract 

Neglected cervical tuberculosis (TB) in a 13-year-old girl with extensive prevertebral abscess extending from C1-T4 is presented along with the plain radiographic and computed tomographic findings. The tuberculous infection progresses to cause multiple vertebral destructions and quadriplegia due to delayed diagnosis. The diagnosis was made on radiological imaging and confirmed by positive mycobacterium bacilli culture. This case illustrated that delayed diagnosis and treatment of cervical spinal TB can be catastrophic. Hence, we suggest consideration of TB of the spine in the differential diagnosis of any patient presenting with neck/back pain since it can be successfully treated, especially if detected early. We advocated the use of easy operating and low-cost examinations such as tuberculin skin test, abscess puncture (not cut) and pus cultivation especially in developing countries for early diagnosis TB infection.

Keywords: Prevertebral abscess, Quadriplegia, Retropharyngeal abscess, Spine, Tuberculosis