An adult case of purulent meningitis secondary to retropharyngeal and deep neck abscess after treatment of odontogenic infection
Tokuoka, K.; Hamano, H.; Ohta, T.; Tamura, Y.; Shinohara, Y.
Rinsho Shinkeigaku 37(5): 417-419
1997
ISSN/ISBN: 0009-918X PMID: 9294332 Document Number: 473889
Retropharyngeal and deep neck abscess, which may follow odontogenic infection, is uncommon in adults, but can be fatal. Furthermore, bacterial meningitis secondary to this disorder is extremely rare. A 67-year-old man was brought to our hospital because he had developed neck pain, trismus, and disturbance of consciousness over several days. A few days prior to the appearance of neck pain, he had the periodontitis treated. Based on CSF, cervical X-ray and CT findings, he was diagnosed as having bacterial meningitis secondary to deep neck abscess. Culture of the CSF yielded gram-positive cocci, later identified as Gemella species, that is a rare organism for bacterial meningitis. Although the administration of antibiotics and drainage of the abscess resulted in gradual improvement of the infectious process, neurologically he remained with apallic syndrome. We would like to stress the importance of odontogenic and pharyngolaryngogenic sources as potential foci of purulent meningitis.