Retropharyngeal abscess with atlanto-axial subluxation

Abstract

We describe a case of a 4-year-old boy who presented with fever, neck pain and bilateral non-suppurative cervical lymphadenopathy. Torticollis, painful limitation of neck movements and nuchal tenderness were present. CT scan revealed a retropharyngeal abscess and rotatory subluxation of the atlanto-axial joint, consistent with Grisel’s syndrome. This is an important differential in children with fever and torticollis as if unrecognized, may potentially lead to serious neurological deficits from cervical cord compression.