Osteomyelitis of the Odontoid Process Associated With Meningitis and Retropharyngeal Abscess

A 52-year-old man complaining of headache and nuchal pain was treated initially under a diagnosis of bacterial meningitis. The meningitis resisted antibiotic therapy, and one week later was complicated by a ruptured retropharyngeal abscess, which led to the correct diagnosis of osteomyelitis of the odontoid process of the axis. His neck was immobilized in a high neck collar and the retropharyngeal abscess was treated by repeated drainage and irrigation. A long course of antibiotic administration finally resolved the infection. Osteomyelitis of the odontoid process is rare and presents with peouliar signs and symp-toms. Careful consideration of the differential diagnosis is needed for the early detection of this poten-tially serious condition.