Clinical communication: Adult| Volume 35, ISSUE 2, P163-165, August 2008

Retropharyngeal Phlegmon in a Hemodialysis Patient with Staphylococcus Aureus Bacteremia

  • Richard I. Lappin
    Reprint Address: Richard I. Lappin, md, phd, Department of Emergency Medicine, New York-Presbyterian Hospital, 525 East 68th Street, New York, NY 10021
    Department of Emergency Medicine, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
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  • Jeffrey Silberzweig
    Rogosin Institute Manhattan Dialysis Center, New York, New York

    Rogosin Institute Queens Dialysis Center, Woodside, New York

    Division of Nephrology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
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Published:February 22, 2008DOI:


      Staphylococcus aureus bacteremia is a frequent occurrence in patients with indwelling catheters. Endocarditis, osteomyelitis, and septic arthritis are common metastatic complications. A hemodialysis patient developed fever, headache, neck pain, sore throat, and dysphagia in the setting of S. aureus bacteremia. Contrast computed tomography scan of the neck revealed a retropharyngeal phlegmon. Recurrent bacteremia led to the identification of the access graft as the infectious source. We present this case to increase awareness among emergency physicians that retropharyngeal infection by S. aureus can arise by hematogenous spread and should be considered in the differential diagnosis of a bacteremic patient with sore throat or neck pain.


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