Retropharyngeal abscess: Difference between revisions
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==Background== | ==Background== | ||
* | *Polymicrobial abscess in space between posterior pharyngeal wall and prevertebral fascia | ||
* | *Adults: Due to direct extension of purulent debris from adjacent site (e.g. Ludwig angina) | ||
***Due to | **More likely to extend into the mediastinum | ||
*Children: Due to suppurative changes within a lymph node (primary infection elsewhere in head or neck) | |||
==Clinical Features== | |||
*Sore throat (76%) | |||
*Fever (65%) | |||
*Torticollis (37%) | |||
*Dysphagia (35%) | |||
*Late symptoms: | |||
**Stridor, respiratory distres, chest pain (mediastinitis) | |||
==Diagnosis== | ==Diagnosis== | ||
* | *CT neck w/ IV contrast | ||
**Gold standard | |||
** | |||
==Treatment== | ==Treatment== | ||
*Emergent ENT consult | |||
**Most patients require I&D | |||
*Secure airway | *Secure airway | ||
*Abx | *Abx | ||
** | **Clindamycin 600-900mg IV OR | ||
* | **Cefoxitin 2gm IV | ||
==Disposition== | ==Disposition== | ||
Admit | *Admit | ||
==Source== | ==Source== | ||
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[[Category:Peds]] | [[Category:Peds]] | ||
[[Category:ID]] | |||
Revision as of 12:40, 21 November 2011
Background
- Polymicrobial abscess in space between posterior pharyngeal wall and prevertebral fascia
- Adults: Due to direct extension of purulent debris from adjacent site (e.g. Ludwig angina)
- More likely to extend into the mediastinum
- Children: Due to suppurative changes within a lymph node (primary infection elsewhere in head or neck)
Clinical Features
- Sore throat (76%)
- Fever (65%)
- Torticollis (37%)
- Dysphagia (35%)
- Late symptoms:
- Stridor, respiratory distres, chest pain (mediastinitis)
Diagnosis
- CT neck w/ IV contrast
- Gold standard
Treatment
- Emergent ENT consult
- Most patients require I&D
- Secure airway
- Abx
- Clindamycin 600-900mg IV OR
- Cefoxitin 2gm IV
Disposition
- Admit
Source
Tintinalli