Infected Thornwaldt Cyst: Case Report of an Unusual Cause of Pediatric Neck Pain

Nicholas B Dimenstein; Caitlin E Crumm; Eve Champaloux; Rebekah Burns

doi:10.1016/j.jemermed.2023.02.027

Infected Thornwaldt Cyst: Case Report of an Unusual Cause of Pediatric Neck Pain

J Emerg Med. 2023 Jun;64(6):726-729. doi: 10.1016/j.jemermed.2023.02.027. Epub 2023 Mar 8.

Authors

Nicholas B Dimenstein¹, Caitlin E Crumm², Eve Champaloux³, Rebekah Burns²

Affiliations

¹ Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, Washington. Electronic address: nicholas.dimenstein@gmail.com.
² Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, Washington.
³ Department of Otolaryngology, University of Washington, Seattle, Washington.

PMID: 37202267
DOI: 10.1016/j.jemermed.2023.02.027

Abstract

Background: The differential diagnosis for pediatric neck pain is broad and includes benign and life-threatening entities. The neck is a complex structure with many compartments. Rare disease processes exist that can mimic more serious conditions, such as meningitis.

Case report: We present a case of a teenager with several days of severe pain underneath her left jaw, limiting the motion of her neck. After laboratory and imaging evaluation, the patient was found to have an infected Thornwaldt cyst and was subsequently admitted for IV antibiotic treatment. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Including infected congenital cysts on the differential for pediatric neck pain can help ensure appropriate use of invasive procedures, such as lumbar puncture. Missed cases of infected congenital cysts could lead to patients returning to the emergency department with persistent or worsened symptoms.

Keywords: Thornwaldt cyst; neck; neck pain; pediatric emergency medicine.

Publication types

Case Reports

MeSH terms

Adolescent
Child
Cysts*
Female
Humans
Neck
Neck Pain* / etiology