Department of Pediatric and Child Health, Aga Khan University Hospital, Karachi, Pakistan.
Department of ENT, Aga Khan University Hospital, Karachi, Pakistan.
J Med Case Rep. 2023 Aug 27;17(1):367. doi: 10.1186/s13256-023-04101-x.
Deep neck space infections are uncommon in infants. Retropharyngeal abscess (RPA) is a deep space neck infection that can present with subtle signs and symptoms. Delay in diagnosis can lead to life-threatening complications. Here we describe life-threatening complication of retropharyngeal abscess.
We report a life-threatening complication of retropharyngeal abscess in 10-month old Asian infant weighing 8.2 kg. The patient presented with fever, right-sided neck swelling, hoarseness of voice, and respiratory distress. The clinical and radiological findings were suggestive of airway obstruction complicated by retropharyngeal abscess. The patient was urgently taken to the operating room and underwent (grade 3) intubation. After stabilization, the patient underwent endoscopic trans-oral incision and drainage, during which 5 cc pus was aspirated. Antibiotics were prescribed for 2 weeks following the procedure based on the sensitivity result of the pus culture.
In retropharyngeal abscess, a delay in diagnosis can result in life-threatening complications. This report highlights the importance of prompt recognition of a threatened airway and the management of retropharyngeal abscess by emergency physicians. If an emergency physician suspects RPA with airway obstructions, the airway should be immediately secured in a secure environment by otolaryngologist and an anesthesiologist.
深部颈部感染在婴儿中并不常见。咽后脓肿（RPA）是一种深部颈部感染，其表现可能不明显。诊断的延迟可能导致危及生命的并发症。在这里，我们描述了咽后脓肿的危及生命的并发症。
我们报告了一例 10 个月大的亚洲婴儿的危及生命的咽后脓肿并发症，体重 8.2 公斤。该患者表现为发热、右侧颈部肿胀、声音嘶哑和呼吸困难。临床和影像学检查结果提示存在气道阻塞，并发咽后脓肿。患者被紧急送往手术室，并进行（3 级）插管。稳定后，患者接受了经口内镜下切开引流术，期间吸出了 5 毫升脓液。根据脓液培养的药敏结果，在术后 2 周内开具了抗生素。
在咽后脓肿中，诊断的延迟可能导致危及生命的并发症。本报告强调了急诊医生及时识别威胁气道和管理咽后脓肿的重要性。如果急诊医生怀疑有气道阻塞的咽后脓肿，应立即由耳鼻喉科医生和麻醉师在安全的环境中保护气道。
