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Retropharyngeal abscess
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
A peripheral IV is placed and she receives a normal saline fluid bolus of 20 mL/kg. The lateral neck radiograph and neck CT are obtained. What is seen in the lateral neck radiograph and what are the potential pitfalls in interpretation? What is seen in the CT scan of the neck?What organisms are seen in a retropharyngeal abscess?What are the complications associated with a retropharyngeal abscess?
Cervicofacial Infections
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Retropharyngeal abscess is now uncommon but should be recognized because of its potential to cause fatal airway obstruction.12 The child is usually febrile, drooling and may adopt a characteristic posture with the neck flexed and the head extended. If suspected, the child must be admitted for intravenous antibiotics, rehydration and careful observation. Imaging is required to confirm the suspected clinical diagnosis, distinguish between drainable abscesses and cellulitis, define the precise extent of the disease, identify complications and also monitor infection progression. CT scanning with contrast is the modality of choice but may itself require anaesthesia (Figure 37.4).13 In patients requiring a general anaesthetic the patient should be carefully intubated with the help of a skilled paediatric anaesthetist and arrangements should be made for surgical drainage if indicated as soon as the CT scan has been completed. Drainage can be via an intraoral or external approach.
The neck
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
The patient, more commonly a child than an adult, complains of neck pain and stiffness. In neglected cases a retropharyngeal abscess may cause difficulty in swallowing or swelling at the side of the neck. On examination the neck is extremely tender and all movements are restricted. In late cases there may be obvious kyphosis (Figures 17.33 and 17.34), a fluctuant abscess in the neck (Figure 17.35) or a retropharyngeal swelling. The limbs should be examined for neurological defects.
Retropharyngeal abscess in the setting of multisystem inflammatory syndrome in children
Published in Baylor University Medical Center Proceedings, 2022
Darshan B. Patel, Madison L. Buras, Kimberly Walter, Gueorgui Dubrocq
A 13-year-old boy with COVID-19 infection 3 weeks earlier presented with a 4-day history of sore throat, left ear pain, headache, fever, and fatigue. Computed tomography (CT) of the neck was consistent with retropharyngeal abscess, as it was notable for a retropharyngeal fluid collection and soft tissue fullness of the left parapharyngeal region (Figure 1a). Physical examination was notable for significant swelling of both tonsils with the presence of tonsillar exudate and left-sided adenopathy at the angle of the mandible and neck. The white blood cell count was 16 × 109 cells/L, with granulocytes of 14 × 109 cells/L. C-reactive protein was 95 mg/L. A COVID-19 polymerase chain reaction study was positive at the outside emergency department.
Retropharyngeal abscess as a paradoxical reaction in a child with multi-drug-resistant tuberculosis
Published in Paediatrics and International Child Health, 2019
Lavina Desai, Ira Shah, Manohar Shaan
Tuberculous paradoxical reactions (PRs) are poorly described in the paediatric literature. An incidence of 14% was reported in Canada, 10% in Belgium and 9.8% in Spain [1–3]. Most of the common PR reported in the paediatric literature is tuberculomas, pleural effusion, increasing size or new appearance of lymph nodes and abscesses [4]. A literature search of PubMed and Google Scholar found no previous reports of retropharyngeal abscess owing to a PR. An adolescent girl with multi-drug-resistant tuberculosis (MDR-TB) developed a recurrent asymptomatic retropharyngeal abscess while on anti-tuberculous therapy (ATT) which required multiple aspirations.
Microvascular reconstruction after extensive cervical necrotizing fasciitis: A case series
Published in Acta Oto-Laryngologica Case Reports, 2019
Rajan P. Dang, Joseph P. Bradley, Joseph Zenga, Patrik Pipkorn
A 67-year-old male with a past medical history of chronic obstructive pulmonary disease and congestive heart failure presented with acutely worsening neck swelling and airway compromise. He had no history of immunosuppression, diabetes, IV drug use, or other risk factors for severe necrotizing infection. Home medications included only simvastatin and lisinopril. Imaging was notable for an 8-cm retropharyngeal abscess extending into the deep spaces of the left neck with soft tissue gas extending to the anterior mediastinum (Figure 3(A)).