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Retropharyngeal abscess and Epstein-Barr virus infection in children
1Division of Pediatric Otolaryngology-Head and Neck Surgery, Babies and Children's Hospital of New York, Columbia-Presbyterian Medical Center, New York 10032, USA.
Insights
Epstein-Barr virus (EBV) infection may play a role in pediatric retropharyngeal abscess (RPA) formation. Four of seven patients showed signs of acute EBV, with older children experiencing more severe RPA.
Area of Science:
- Pediatric Infectious Diseases
- Otolaryngology
- Virology
Background:
- Retropharyngeal abscess (RPA) is a serious neck infection in children.
- The specific etiology and contributing factors for RPA are not fully understood.
- Epstein-Barr virus (EBV) is a common viral infection with diverse clinical manifestations.
Purpose of the Study:
- To investigate the potential association between acute Epstein-Barr virus (EBV) infection and the development of retropharyngeal abscess (RPA) in pediatric patients.
- To identify clinical and serological characteristics of pediatric RPA patients with concurrent EBV infection.
Main Methods:
- A 6-year retrospective chart review was performed at Columbia-Presbyterian Medical Center.
- Pediatric patients diagnosed with RPA were analyzed for signs, symptoms, and serologic findings suggestive of acute EBV infection.
- Serological tests for EBV immunoglobulin G (IgG) antibodies were reviewed.
Main Results:
- Seven pediatric patients with RPA were identified.
- Four of the seven patients had elevated IgG antibodies consistent with recent acute EBV infection.
- Patients with positive EBV titers presented with typical EBV symptoms: fever, lymphadenopathy, and pharyngitis.
- Two older patients (ages 11 and 18) experienced more severe RPA infections.
Conclusions:
- Acute Epstein-Barr virus (EBV) infection may be a contributing factor in the pathogenesis of retropharyngeal abscess (RPA) in children.
- Increasing age may be associated with more severe presentations of EBV-associated RPA.
- Further research is warranted to elucidate the role of EBV in pediatric RPA.
Abstract:
A 6-year retrospective chart review was conducted of all pediatric patients with the diagnosis of retropharyngeal abscess (RPA) at the Columbia-Presbyterian Medical Center. The charts were examined for signs, symptoms, and serologic findings consistent with recent acute Epstein-Barr virus (EBV) infection. Of the 7 patients we studied, 4 had elevated immunoglobulin G antibodies that were consistent with recent acute EBV infection, and 3 patients were not tested. The 4 patients with positive titers also presented with signs typical for acute EBV infection, including fever (3/4), lymphadenopathy (4/4), and pharyngitis (4/4). Of note, the 2 patients who were older than expected for RPA (ages 18 and 11) had the most severe infections. We submit that there may be a role for EBV infection in the pathogenesis of RPA formation in children. Increasing age may correlate with a more severe infection in this setting.