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Empyema as a complication of retropharyngeal and neck abscesses in children
Insights
Retropharyngeal abscesses can rarely lead to empyema in infants. This study describes cases where neck abscesses spread to the chest, highlighting cervicothoracic disease pathways.
Area of Science:
- Pediatric Surgery
- Thoracic Medicine
- Infectious Diseases
Background:
- Retropharyngeal abscesses are infections in the neck, posterior to the pharynx.
- Empyema is a collection of pus in the pleural space of the chest.
- Cervicothoracic disease involves interconnected pathological processes between the neck and chest.
Observation:
- Two infants presented with symptoms and chest X-rays suggestive of pleural fluid, potentially from a retropharyngeal abscess.
- A child with submandibular and cervical abscesses developed pleural and mediastinal abscesses within 24 hours of admission.
Findings:
- Pathological processes in the neck can extend into the chest via direct continuity or fascial plane dissection.
- The visceral space, continuous with the mediastinum, is a key area for cervicothoracic disease interrelation.
Implications:
- Understanding these pathways is crucial for diagnosing and managing rare cervicothoracic infections.
- Early recognition of neck abscess complications can prevent severe thoracic infections like empyema.
- This highlights the importance of considering chest involvement in pediatric neck abscess cases.
Abstract:
Empyema developing from retropharyngeal abscess is a rare complication. Two infants with clinical symptomatology and inital chest radiographic findings of pleural fluid which suggested the possibility of retrophoryngeal abscess are described. A child with submandibular and cervical abscesses is also reported; pleural fluid and mediastinal abscess developed less than 24 hours after admission. Pathological processes in the neck can spread into the chest or conversely, either by direct continuity or by dissection through the fascial planes enveloping the cervical compartments. The middle or visceral space which is in direct continuity with the mediastinum is generally the area in which cervicothoracic disease inter-relates.