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A 63-year-old man presented to the ED with severe neck pain after turning his neck.

Plain films were reassuring and he was neurologically intact, so he was discharged.

A few hours later he presented to the main campus ED with worsening pain.

MRI and CT of his cervical spine and neck were done.

There was concern for a retropharyngeal phlegmon vs abscess, in addition to cervical spine stenosis.

He also was found to have worsening ankle pain, and diagnosed with a septic joint.

The patient was taken to the OR by orthopedics, with ENT also attempting to surgically access the possible abscess with Lindholm and Dedo laryngoscopes.

The patient was placed in significant neck hyperextension throughout the surgery.