An Unusual Case of Retropharyngeal Tubercular Abscess Due to Cervical Pott's Spine with Mediastinal Tubercular Lymphadenopathy: A Case Report

Introduction: Tuberculosis (TB) including extrapulmonary tuberculosis is one of the most common diseases in developing countries like India. Spinal tuberculosis (Pott's spine) usually involves thoracolumber spine and rarely affects cervical spine. In addition retropharyngeal abscesses of tubercular origin are also one of rare presentations of cervical spine tuberculosis. Case description: We present a rare case of a 27-year-old female with a history of tubercular retropharyngeal abscess (RPA) associated with spinal tuberculosis (TB) (Pott's spine) involving the cervical spine. The patient was successfully managed with drainage of the abscess and antitubercular treatment (ATT). She later on had a recurrence of extrapulmonary TB in the form of mediastinal lymph node mass (drug-sensitive TB), which is rare in adults and was treated successfully with ATT. Such recurrence of extrapulmonary TB (drug-sensitive) in previously successfully treated cases of retropharyngeal tubercular abscess is an uncommon presentation of TB. Conclusion: Retropharyngeal abscess is one of the rare presentations of cervical Pott's spine. Despite its rarity, it should be aggressively treated due to life threatening complications. In case of its recurrence; other extrapulmonary lesions like mediastinal lymphadenopathy should be considered in diagnostic workup.