Retropharyngeal Abscess in a Four Month Old Female Infant-Case Report

Abstract

Retropharyngeal abscess is acute suppurative infection of the retropharyngeal space. Most commonly it occurs in children younger than four years of age having history of streptoccocal pharyngitis. Clinical presentation similar to epiglottitis or foreign body aspiration makes distinguishing issues so the diagnosis of retropharyngeal abscess can initially be missled. Here we are illustrating four month old female infant with incipient presentation that clinically resembles epiglottitis. After the initial management in the intensive care unit clinical work-up was continued with multidysciplinary collaboration and the diagnosis of retropharyngeal abscess was given, treated both surgically and conservatively. Postoperative intensive care was then continued with subsequent clinical and biochemical improvement. This case demonstrates the need for broad thinking when dealing with affebrile child being respiratory distressed and during diagnostic work-up of a patient having fever of unknown origin.

Retropharyngeal abscess, submandibular abscess, and regio colli abscess with bronchopneumonia in a 2.5-month-old boy

“…As far as we found in the literature, there are rare cases of development of retropharyngeal abscess at this early age. 2 Predominantly male (2:1) with seventy percent of the patients are younger than six years of age. 6 Infections of upper respiratory tract are common in infants and young children, usually presented with cough, coryza and poor oral intake.…”

“…On anamnesis in our patient, there was cough, coryza, poor oral intake, unilateral neck swelling that suggest there was a deep neck infection. 2 Cervical bacterial infection may result from endogenous oropharyngeal, nasal or dental flora or skin infections on the scalp or face or from person-to-person spread by airborne droplets. Prompt diagnosis and treatment of bacterial cervical infection are important due to the presence of so many vital structures in proximity.…”

“…It most commonly occurs in children younger than four years of age having medical history of streptococcal pharyngitis, rarely as a complication of recent trauma, odontogenic infection or extension of vertebral osteomyelitis. 2 Most frequently causative agents are S. aureus and group A β-haemolytic streptococcus (GABHS, Streptococcus pyogenes), followed by anaerobic bacteria Fusobacterium and Bacteroides. Also, Haemophilus influenzae, Klebsiella sp, Mycobacterium tuberculosis and M. avium-intracellulare can be found.…”

“…Also, Haemophilus influenzae, Klebsiella sp, Mycobacterium tuberculosis and M. avium-intracellulare can be found. 2 In young infants, nasopharyngeal infection may be common, but secondary retropharyngeal abscess formation is rare. In the event that a retropharyngeal abscess-does develop, Group B…”

“…Loss of physiological cervical lordosis can also be seen. 2 Retropharyngeal abscess is a result of suppuration of paramedian lymph nodes following an upper respiratory infection. 1 Management often consists of antimicrobial therapy and surgical drainage.…”