1487: Abrupt Paralysis, Not Your Typical Sore Throat Complication

Introduction: A retropharyngeal abscess is a rare condition that can be life-threatening with a multitude of complications. A retropharyngeal abscess is an infection of the deep neck space that typically starts from a viral or bacterial infection of the upper respiratory tract, dental disease, or trauma to the oropharynx. The objective of this case report is to add to the limited literature regarding this rare complication of a retropharyngeal abscess. Description:: A 65-year-old previously healthy male with a history of tobacco use, presented to the emergency department with one week of worsening neck pain, stiffness in his neck, sore throat, and a sudden episode of complete left arm and left leg paralysis during evaluation in the emergency department. Discussion: A 65-year-old previously healthy male with a history of tobacco use, presented to the emergency department with one week of worsening neck pain, stiffness in his neck, sore throat, and a sudden episode of complete left arm and left leg paralysis during evaluation in the emergency department. Prior to the presentation at our institution, the patient was seen at an urgent care, another emergency department, and his orthopedic, who had previously administered steroid injections to the C-Spine area. During the patient’s time in the emergency department, he developed sudden-onset complete paralysis of the left upper and left lower extremities. A CT scan of the cervical spine without contrast and a CT scan of the soft tissue neck with contrast were obtained and revealed a large retropharyngeal abscess with an extensive fluid collection compressing the spinal cord in the cervical spine. The patient underwent C2-C6 spinal decompression fusion at our facility. He was subsequently transferred out to another facility for ENT drainage of the retropharyngeal abscess, where he was also found to have Staph aureus bacteremia. He had a successful drainage of the retropharyngeal abscess and was treated with IV antibiotics for the bacteremia. After a few days, he was discharged home with full mobility and complete resolution of all symptoms.