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  • Title: Acute cervical osteomyelitis and prevertebral abscess after routine tonsillectomy.
    Author: Patel AA, Madigan L, Poelstra KA, Whang PG, Vaccaro AR, Harrop JS.
    Journal: Spine J; 2008; 8(5):827-30. PubMed ID: 17697802.
    Abstract:
    BACKGROUND CONTEXT: Tonsillectomy is among the most commonly performed surgical procedures. The development of severe infection after tonsillectomy is a very rare but potentially fatal complication that has not been described in the orthopedic, neurosurgical, or spine literature. PURPOSE: To present acute cervical osteomyelitis and prevertebral abscess formation as a complication of a routine tonsillectomy. STUDY DESIGN: Case report, literature review. METHODS: A case report was prepared on the clinical and radiographic data of a patient presenting with prevertebral abscess and acute cervical osteomyelitis 6 weeks after routine tonsillectomy. A review of relevant literature was additionally performed. RESULTS: The patient presented 6 weeks after tonsillectomy with evidence of a deep cervical infection. Operative debridement with anterior and posterior surgical stabilization was performed. The patient completed a 6-week course of intravenous antibiotics. At 24-month follow-up, the patient showed no signs of infection and demonstrated a stable fusion mass. CONCLUSIONS: The development of prevertebral abscess and acute cervical osteomyelitis has been discussed in a small number of otolaryngology case reports and has not been previously reported in the orthopedic, neurosurgical, or spine literature. Symptoms may be nonspecific, and so a high index of clinical suspicion is needed. Delay in treatment may lead to significant morbidity and even mortality. Successful treatment can be obtained through operative debridement and intravenous antibiotic therapy.
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