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Kicking off a Retropharyngeal Abscess
A Rana1, L Heffernen1, J Binchy1
1Department of Emergency Medicine, University Hospital Galway, Ireland
Irish Medical Journal
|May 25, 2019
Summary
A retropharyngeal abscess (RPA) can be life-threatening. This case shows trauma can mask RPA symptoms, delaying diagnosis in a child with neck pain.
Area of Science:
- Deep neck space infections
- Pediatric emergency medicine
- Diagnostic challenges in deep neck infections
Background:
- Retropharyngeal abscesses (RPAs) are serious deep neck infections that can lead to airway compromise.
- Prompt diagnosis and treatment are crucial for favorable outcomes.
Observation:
- A 3-year-old girl presented with neck pain and limited range of motion after a sibling's kick.
- Initial examination and cervical spine X-ray suggested a facet joint injury, delaying RPA diagnosis.
- The patient lacked typical RPA symptoms, making the traumatic history a misleading factor.
Findings:
- Magnetic Resonance Imaging (MRI) ultimately revealed a retropharyngeal abscess.
- The abscess was successfully treated with incision, drainage, and antibiotics.
- This case underscores the atypical presentations of RPAs in pediatric patients.
Implications:
- Physicians must consider retropharyngeal abscesses even when trauma is the presenting complaint.
- Unusual presentations of deep neck infections require a high index of suspicion.
- Trauma history can be a diagnostic red herring, necessitating comprehensive evaluation.
