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Pyogenic osteomyelitis of the occiput, the atlas, and the axis. A report of five cases.

Pyogenic osteomyelitis rarely affects the first and second cervical vertebrae, and when it does it can progress to abscess formation, compressing the spinal cord. If the process is unrecognized, it can be fatal. The cases of five patients are reported. Two patients were treated by anterior débridement and posterior cervical-occipital arthrodesis; one, by transoral drainage; one, by posterior cervical-occipital arthrodesis; and the fifth, by posterior atlanto-axial arthrodesis. The causative organism was Staphylococcus aureus in four patients and Pasteurella multocida in one. In all patients, intravenous antibiotics were used, followed by prolonged administration of oral antibiotics. All five patients recovered.