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Retropharyngeal space infection: changing trends
G J Gianoli1, T E Espinola, J L Guarisco
1Department of Otolaryngology-Head and Neck Surgery, Tulane University Medical Center, New Orleans, LA 70112.
Abstract:
Retropharyngeal space infection, now a rare entity since the introduction of modern antibiotic chemotherapy, has traditionally been described to occur in children less than 4 years of age with suppurative disorders of the ear, nose, and throat. Recent reports suggest a changing trend in the epidemiology, bacteriology, diagnostic imaging, treatment, and clinical course of this entity. However, the medical literature concerning this topic over the last two decades has consisted mainly of case reports. We reviewed eight cases of retropharyngeal space infection at our institutions over a 15-year period, representing one of the largest clinical series of its kind in the last 20 years. Patient ages ranged from 3 months to 41 years. Findings of these cases and 13 cases from similar reports obtained by a MEDLINE computer search of the recent literature were analyzed. Results show a trend toward occurrence in older age groups, polymicrobial infections, successful use of CT scan as a diagnostic modality, and fewer patients requiring incision and drainage. These findings will be discussed and contrasted to conventional wisdom.
Insights
Retropharyngeal space infections are increasingly affecting older patients and are often polymicrobial. Computed tomography (CT) scans are effective for diagnosis, with fewer cases requiring surgical drainage.
Area of Science:
- Infectious Diseases
- Otolaryngology
- Pediatric Medicine
Background:
- Retropharyngeal space infections were historically common in young children with ENT infections.
- Modern antibiotics have made these infections rare, leading to a scarcity of recent large-scale studies.
- Evolving trends in epidemiology, bacteriology, diagnostics, and treatment necessitate updated understanding.
Purpose of the Study:
- To analyze recent trends in retropharyngeal space infections.
- To compare current findings with traditional understanding of the disease.
- To investigate changes in patient demographics, causative agents, diagnostic methods, and treatment outcomes.
Main Methods:
- Retrospective review of eight retropharyngeal space infection cases over 15 years.
- Inclusion of 13 additional cases from a MEDLINE search of recent literature (last 20 years).
- Analysis of patient age, infection characteristics, diagnostic imaging, and treatment modalities.
Main Results:
- Observed a shift towards older patient age groups (3 months to 41 years).
- Identified a trend towards polymicrobial infections.
- Demonstrated the utility of CT scans in diagnosis.
- Noted a decrease in the need for incision and drainage.
Conclusions:
- Retropharyngeal space infections show changing epidemiological and clinical patterns.
- Diagnosis is aided by CT scans, and surgical intervention is less frequently required.
- Findings challenge traditional views on the typical patient profile and management.