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BMJ Case Rep. 2010; 2010: bcr0420102933.
Published online Dec 6, 2010. doi:  10.1136/bcr.04.2010.2933
PMCID: PMC3029038
Unexpected outcome (positive or negative) including adverse drug reactions
An infected branchial cyst complicated by retropharyngeal abscess, cervical osteomyelitis and atlanto-axial subluxation
Richard Bullock,1 Deanne P Soares,1,2 and Marsha James3
1Section of Radiology, Department of Surgery, Radiology, Anaesthetics and Intensive Care, University of the West Indies, Kingston, Jamaica
2Department of Radiology, University Hospital of the West Indies, Kingston, Jamaica
3Department of Otorhinolaryngology, Bustamante Hospital for Children, Kingston, Jamaica
Correspondence to Richard Bullock, richardbullock801/at/msn.com
Abstract
We present a case of a 44-year-old man who visited his general practitioner for recurrent neck swelling, which was found to be a neck abscess. It was aspirated, later recurred, and then surgically excised. Histology was consistent with an infected branchial cyst. Eight months after discharge, the patient presented with a history of progressive neck pain and stiffness and eventually bilateral upper limb weakness. MRI demonstrated a prevertebral abscess complicated by cervical osteomyelitis and atlanto-axial instability. The abscess was drained and appropriate antibiotic treatment was administered. The patient responded well with full recovery of his upper limb strength and resolution of the abscess. However, he had mild persistent neck stiffness.
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