An unusual cause of stridor: retropharyngeal cold abscess

Abstract

A 15-month-old female presented with a large swelling on the left lateral aspect of the neck and respiratory distress, and stridor due to incomplete obstruction of the upper airway. A lateral X-ray film and computerized tomography scan of the cervical spine showed a retropharyngeal abscess without vertebral involvement. Aspiration and contrast revealed it to be a bilobed tubercular abscess. Planned external drainage was done after 10 days under anti-tubercular drugs.

A rare case of tuberculous abscess causing airway obstruction in a paediatric patient in South-East Asia

“…Compared to other lymph nodes in the head and neck region, retropharyngeal nodes are not palpable, which can lead to a rather late presentation of upper airway obtruction caused by bulging of the posterior pharyngeal wall. Furthermore, as occurred in this case, upper airway obstruction is an exceedingly rare presentation of tuberculous abscess [3] . This is the seventh reported case of tuberculous retropharyngeal abscess in the paediatric age group in the world.…”

“…This is the seventh reported case of tuberculous retropharyngeal abscess in the paediatric age group in the world. Of the 6 reported, 4 of them presented with stridor, and 2 of the 4 did not have any cervical spine involvement, as in this case [3,[11][12][13][14][15] . An additional point to note in our case, is the child's initial presentation of obstructive sleep apnoea.…”

“…In cases involving cervical spine tuberculosis as the cause of the retropharyngeal abscess, the presentation was longer, within months. In cases without cervical spine tuberculosis, the presentation was more acute ranging from days up to 2 weeks [3,[11][12][13][14][15][16] .…”

Retropharyngeal SOL: An unusual presentation of a multifaceted entity

“…[ 13 ] TRA developing in the absence of cervical spine TB is extremely rare, and only a handful of cases have been reported from India [ Table 1 ]. [ 9 14 15 16 17 ] Four of these five previously reported cases had TB reported at other sites as well, and pus culture was the technique for a confirmatory diagnosis.…”

Retropharyngeal abscess as a rare presentation of pulmonary tuberculosis

“…However, there are only three case reports of tubercular retropharyngeal abscesses without cervical spine involvement. [ 5 6 7 ] Herein, we would like to draw attention to the fact that retropharyngeal abscesses can be the presenting features of pulmonary tuberculosis without involvement of the cervical spine. Early radiological investigations to screen for pulmonary tuberculosis and early empirical treatment based on radiological diagnosis alone, in case of a small abscess, can be useful to prevent serious complications.…”