A case of retropharyngeal tuberculosis: the simple management of a serious case

The challenge in management of chronic retro-pharyngeal abscess lies in its proximity to vascular and neurological structures, the access to the abscess should be possible after evaluation of neurological stability and integrity of vascular structures. Tuberculous chronic retro-pharyngeal abscess is an unusual situation. And due to its scarcity, it is not considered in differential diagnosis which delays its management: this could lead to permanent neurological deficit and higher rates of mortality. This the case of a young 29-year-old male, already undergoing anti-tuberculosis treatment for 2 months for a tuberculous lymphatitis, and no history of immuno-suppression, presenting with a large retropharyngeal abscess, with no neurological symptoms or any other specific symptoms. The management of this disease can be simple provided the diagnosis is not delayed, the patient had no complications, and the follow up is performed by a team: otolaryngologist, a neurosurgeon and a phthisiology specialist.<p> </p>

Laser ablation and management of a retropharyngeal abscess caused by Corynebacterium pseudotuberculosis in a ram

A one-year-old crossbred ram presented for acute respiratory distress. Initial diagnostics revealed compression of the pharynx by a spherical, avascular mass. The ram was initially managed with a tracheostomy, antimicrobials and non-steroidal anti-inflammatories. Advanced imaging confirmed a pharyngeal abscess which was lanced via endoscopic-guided laser procedure. While synergistic haemolysin inhibition (SHI) testing was negative, Corynebacterium pseudotuberculosis was cultured from the exudate, indicating a false negative result by the SHI test and the potential for a lack of reliability of this test in sheep with internal abscessation. Clinicians should be aware of the utility of diagnostic imaging as well as the use of endoscope-guided laser procedures in areas where traditional surgical approaches are challenging, such as the upper airway of sheep.