28 1 1a 1b 2 MRI T2 3 CT C3 N95 N95 6ml 90

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1 CT C3 Tb PCR XP WBC 7 600/mm 3 CRP 4 08mg/dl MRI MRI CT MRI WBC 9 700/mm 3 CRP 6 09mg/dl CT C3 C2 C7 low density area CT 89

2 28 1 1a 1b 2 MRI T2 3 CT C3 N95 N95 6ml 90

3 CT C2 C7 low density area 5 CT PCR 91

4 N95 Tb PCR CT MRI,,,..,,,,..,,,....,,..,, Cain KP, Benoit SR, Winston CA, et al. Tuberculosis among foreign bom persons in the United States. JAMA 2008 ; 300 : French CE, Antoine D, Gelb D, et al. Tuberculosis in non UK bom persons, England and Wales,

5 28 1 Int J Tuberc Lung Dis 2007 ; 11 : A case of tuberculous with a retropharyngeal abscess Hironari Shimizu and Hiroshi Shinohara Department of Otolaryngology, Kawakita General Hospital We report herein on a rare case of tuberculosis with a retropharyngeal abscess. The patient was a 27 year old woman complaining of neck pain, who has immigrated to Japan from Nepal one and a half years previously. She visited Kawakita General Hospital Department of Orthopedics initially and X ray imaging revealed no abnormal findings. She wasthenrefferedtothee.n.t. department since she also complained of a swallowing pain. The laryngeal fiberscopy showed no tumor growth or inflammation. Three months later, she went to the ER of a nearby hospital with a headache. At that hospital, CT and MRI were performed and the findings suggested a retro pharyngeal abscess. She was admitted to our hospital and cervical CT showed an erosion of the cervical vertebra without fever or inflammatory findings. We suspected a cold abscess and spinal caries. Chest CT revealed several cavities in the upper lobe of the right lung. Puncture of the retropharyngeal abscess was carried out and the polymerase chain reaction PCR technique showed Mycobacterium tuberculosis in the pus. No other samples including sputum or gastric juice showed infection of M. tuberculosis. The patient was referred to a hospital specializing in tuberculosis where and anti tuberculosis medicines were administered for 6 months then the bony lesions were debrided. Key words : spinal caries, tuberculosis, retropharyngeal abscess, Nepal 93

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