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Rare and unexpected cause for retropharyngeal abscess in an immunocompetent man: metastatic community-acquired methicillin-resistant Staphylococcus aureus infection
  1. Venkat Ramesh1,
  2. Sri Ramya Ganti2,
  3. Santosh Gattu1 and
  4. Ratnamani Sharma3
  1. 1Infectious Diseases, Apollo Hospitals, Hyderabad, India
  2. 2Critical Care, Apollo Hospitals, Hyderabad, India
  3. 3Clinical Microbiology, Apollo Hospitals, Hyderabad, India
  1. Correspondence to Dr Venkat Ramesh; venkatramesh.ramesh{at}


Staphylococcus aureus causes clinical diseases ranging from mild skin infections to devastating conditions such as septic shock, endocarditis and osteomyelitis. S. aureus is a common cause of community-acquired bacteraemia. Prolonged bacteraemia may cause metastatic infection, manifesting as endocarditis, osteomyelitis and abscesses. A man in his 20s presented with a short-duration of fever and odynophagia. CT of the neck suggested a retropharyngeal abscess. Retropharyngeal abscesses are typically polymicrobial and caused by resident oral cavity flora. In the hospital, he developed shortness of breath and hypoxia. CT of the chest showed peripheral, subpleural nodular opacities raising suspicion for septic pulmonary emboli. Blood cultures demonstrated the growth of methicillin-resistant S. aureus. The patient completely recovered with antibiotic therapy alone. This is a unique and rare presentation case of metastatic S. aureus bacteraemia, manifesting as a retropharyngeal abscess without any evidence of infective endocarditis on transoesophageal echocardiography.

  • Infections
  • Ear, nose and throat/otolaryngology
  • Pneumonia (respiratory medicine)
  • Radiology
  • Pneumonia (infectious disease)

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  • Contributors SRG and SG wrote the initial manuscript draft, obtained relevant data and obtained patient consent. RS was the clinical microbiologist concerned with the case and prrovided the microbiology images and the initial report. VR was the consultant Infectious Diseases Physician responsible for the patient care with the critical care and microbiology teams, supervised SRG and SG, reviewed and redrafted the full manuscript including the images section, reviewed the references, adjusted the journal template as required, reviewed the patient perspective and submitted the manuscript. VR and RS critically reviewed the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.