Author(s)

Ghassan Skaf^*, Elias Elias

Division of Neurosurgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.

Background: We describe a rare case of Candida albicans retropharyngeal infection with upper cervical spondylodiscitis associated with epidural abscess triggered by ingestion of a chicken bone. Case Description: A 63-year-old woman presented with posterior neck and bilateral shoulders pain three weeks after choking on a 2-centimeter chicken bone. Magnetic resonance imaging (MRI) revealed spondylodiscitis and epidural abscess with significant spinal cord compression at C2 and C3 levels. A Barium swallow showed a focal disruption of the posterior wall of the esophagus. A posterior upper cervical fixation (C2-C5) was initially performed. One week later an anterior decompressive procedure was carried out followed by iliac crest bony fusion, and repair of the esophageal defect. Intra-operative cultures showed heavy growth of Candida albicans. After a transitory post-operative neurologic worsening, and after six weeks of appropriate antifungal therapy, the patient achieved a full clinical and radiologic recovery. Conclusion: Prompt surgical debridement, fusion and stabilization combined with adequate antimicrobial agents are necessary to guarantee a good outcome and reverse the neurological deficits.

Osteomyelitis, Cervical Spine, Discitis, Retropharyngeal Abscess, Candida albicans

Skaf, G. and Elias, E. (2016) Upper Cervical Spine Infection. Complication of Hypopharyngeal Injury. International Journal of Otolaryngology and Head & Neck Surgery, 5, 96-102. doi: 10.4236/ijohns.2016.52016.