Hospital: Hospital Universitario de Canarias.
Aut@r o Autores: I. Jiménez Sosa, A. Rodriguez Fuentes, M.E. Gomez Gil, C. Atienza Sentamans, D. Martin Rodriguez, M.C. Germany Rozas.
A 12 years old female came into the Emergency department afflicted of sore throat, temperature and malaise. A cervical ultrasound was carried out showing several laterocervical inflammatory adenomegalies. One day later, our patient suffered a clinical deterioration with abdominal pain and sepsis. A chest radiography and abdominal ultrasound were performed with no relevant findings. After clinical revaluation, they noticed that the patient presented nasal voice because of that a neck CT with intravenous contrast media was indicated. CT findings were: a rim-enhancing hypoattenuating collection consistent with an abscess located in the retropharyngeal space and left level 2 suppurative lymph node.
Most of retropharyngeal abscesses are caused by the spread of infection from the middle ear, sinuses and upper respiratory tract to retropharyngeal lymph nodes. These abscesses are more frequent and severe in children. The most common clinical manifestations are sore throat, fever and malaise. Complications, as mediastinitis or airway compromise, carry a great morbidity and mortality. Because of that an adequate clinical approach as well as an accurate radiological diagnosis is very important. Neck CT with intravenous contrast material is the technique of choice to make the diagnosis, study the extension and detect possible complications. This test should be done urgently. Thorax must be included in the area of study to detect rule out mediastinal extension of the abscess.
Retropharyngeal abscesses are infrequent, however its complications are severe, so early diagnosis is crucial to apply a prompt effective treatment. Neck CT after intravenous contrast material administration is the imaging modality of choice to make the diagnosis and look for its complications. Thorax must be included in the study to discard mediastinal extension.
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