Retropharyngeal Abscess in a Fourteen-Month-Old Child Presenting with Dysphagia and Obstructive Sleep Apnea: A Case Report

Abstract

Retropharyngeal abscess is a relatively uncommon midline deep neck space infection that extends from the base of the skull to the posterior mediastinum, situated between the buccopharyngeal and alar fascias. In this case report, we present a 14-month-old previously healthy female patient who had a high-grade fever for 7 days, associated with neck stiffness and restriction of neck movements to the right side. Her parents noticed decreased oral intake associated with dysphagia, muffled quality of voice, and obstructive sleep apnea. However, the patient had no clinical signs of mechanical obstruction on examination. A contrast-enhanced computed tomography scan of the neck showed a large retropharyngeal septated fluid collection measuring 8 × 3 × 6 cm, which was categorized as a large retropharyngeal abscess that was complicated by descending mediastinitis. The patient was taken immediately to the operation theater for incision and drainage under general anesthesia, after which she was started on intravenous antibiotics.

Challenges in Diagnosis and Management of Infantile Deep Neck Abscess: A Case Report and Literature Review

“…Due to the patient's unstable condition, an emergency incision and drainage were performed under general anesthesia. The patient was then started on empirical intravenous (IV) ceftriaxone and clindamycin for 10 days before being discharged on oral co-amoxiclav for Staphylococcus aureus -positive pus [ 17 ].…”