Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Pediatric Retropharyngeal Abscess Differential Diagnoses

  • Author: Jason L Acevedo, MD; Chief Editor: Ravindhra G Elluru, MD, PhD  more...
 
Updated: Jul 11, 2016
 
 

Diagnostic Considerations

In addition to the conditions listed in the differential diagnosis, other problems to be considered include the following:

  • Branchial cleft cyst
  • Thyroglossal duct cyst
  • Retropharyngeal thyroid tissue
  • Retropharyngeal tumor
  • Aneurysm
  • Hematoma
  • Tendonitis of longus colli muscle
  • Superficial abscess
  • Ludwig angina
  • Other deep neck space infections
  • Epstein-Barr virus infection

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Jason L Acevedo, MD Otoloaryngologist-Head and Neck Surgeon

Jason L Acevedo, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery

Disclosure: Nothing to disclose.

Coauthor(s)

Rahul K Shah, MD, FACS, FAAP Associate Professor of Otolaryngology and Pediatrics, Associate Surgeon-in-Chief, Medical Director, Peri-operative Services, Children's National Medical Center, George Washington University School of Medicine and Health Sciences; Attending Physician, Department of Otolaryngology, Children's National Medical Center

Rahul K Shah, MD, FACS, FAAP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American College of Medical Quality, American Association for Physician Leadership, American College of Surgeons, Triological Society, Massachusetts Medical Society, Phi Beta Kappa

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

John E McClay, MD Associate Professor of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Dallas, University of Texas Southwestern Medical Center

John E McClay, MD is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Ravindhra G Elluru, MD, PhD Professor, Wright State University, Boonshoft School of Medicine; Pediatric Otolaryngologist, Department of Otolaryngology, Dayton Children's Hospital Medical Center

Ravindhra G Elluru, MD, PhD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American Bronchoesophagological Association, American College of Surgeons, American Medical Association, Association for Research in Otolaryngology, Society for Ear, Nose and Throat Advances in Children, Triological Society, American Society for Cell Biology

Disclosure: Nothing to disclose.

Acknowledgements

Todd J Berger, MD Assistant Professor, Department of Emergency Medicine, Emory University

Todd J Berger is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Orval Brown, MD Director of Otolaryngology Clinic, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center at Dallas

Orval Brown, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American Bronchoesophagological Association, American College of Surgeons, American Medical Association, American Society of Pediatric Otolaryngology, Society for Ear, Nose and Throat Advances in Children, and Society of University Otolaryngologists-Head and Neck Surgeons

Disclosure: Nothing to disclose.

Hosseinali Shahidi, MD, MPH Assistant Professor, Departments of Emergency Medicine and Pediatrics, State University of New York and Health Science Center at Brooklyn

Disclosure: Nothing to disclose.

References
  1. Abdel-Haq N, Quezada M, Asmar BI. Retropharyngeal abscess in children: the rising incidence of methicillin-resistant Staphylococcus aureus. Pediatr Infect Dis J. 2012 Jul. 31(7):696-9. [Medline].

  2. Chirinos JA, Garcia J, Alcaide ML, Toledo G, Baracco GJ, Lichtstein DM. Septic thrombophlebitis: diagnosis and management. Am J Cardiovasc Drugs. 2006. 6(1):9-14. [Medline].

  3. Lander L, Lu S, Shah RK. Pediatric retropharyngeal abscesses: a national perspective. Int J Pediatr Otorhinolaryngol. 2008 Dec. 72(12):1837-43. [Medline].

  4. Schweinfurth JM. Demographics of pediatric head and neck infections in a tertiary care hospital. Laryngoscope. 2006 Jun. 116(6):887-9. [Medline].

  5. Novis SJ, Pritchett CV, Thorne MC, Sun GH. Pediatric deep space neck infections in U.S. children, 2000-2009. Int J Pediatr Otorhinolaryngol. 2014 May. 78(5):832-6. [Medline].

  6. Ridder GJ, Technau-Ihling K, Sander A, Boedeker CC. Spectrum and management of deep neck space infections: an 8-year experience of 234 cases. Otolaryngol Head Neck Surg. 2005 Nov. 133(5):709-14. [Medline].

  7. Agarwal AK, Sethi A, Sethi D, Mrig S, Chopra S. Role of socioeconomic factors in deep neck abscess: A prospective study of 120 patients. Br J Oral Maxillofac Surg. 2007 Oct. 45(7):553-5. [Medline].

  8. Grisaru-Soen G, Komisar O, Aizenstein O, Soudack M, Schwartz D, Paret G. Retropharyngeal and parapharyngeal abscess in children--epidemiology, clinical features and treatment. Int J Pediatr Otorhinolaryngol. 2010 Sep. 74(9):1016-20. [Medline].

  9. Baldassari CM, Howell R, Amorn M, Budacki R, Choi S, Pena M. Complications in pediatric deep neck space abscesses. Otolaryngol Head Neck Surg. 2011 Apr. 144(4):592-5. [Medline].

  10. Makeieff M, Pelliccia P, Mondain M, Machi P. Pseudoaneurysm of the internal carotid artery complicating deep neck space infection. J Pediatr. 2010 Sep. 157(3):510. [Medline].

  11. Uzomefuna V, Glynn F, Mackle T, Russell J. Atypical locations of retropharyngeal abscess: beware of the normal lateral soft tissue neck X-ray. Int J Pediatr Otorhinolaryngol. 2010 Dec. 74(12):1445-8. [Medline].

  12. Freling N, Roele E, Schaefer-Prokop C, Fokkens W. Prediction of deep neck abscesses by contrast-enhanced computerized tomography in 76 clinically suspect consecutive patients. Laryngoscope. 2009 Sep. 119(9):1745-52. [Medline].

  13. Shefelbine SE, Mancuso AA, Gajewski BJ, Ojiri H, Stringer S, Sedwick JD. Pediatric retropharyngeal lymphadenitis: differentiation from retropharyngeal abscess and treatment implications. Otolaryngol Head Neck Surg. 2007 Feb. 136(2):182-8. [Medline].

  14. Malloy KM, Christenson T, Meyer JS, Tai S, Deutsch ES, Barth PC. Lack of association of CT findings and surgical drainage in pediatric neck abscesses. Int J Pediatr Otorhinolaryngol. 2008 Feb. 72(2):235-9. [Medline].

  15. Kirse DJ, Roberson DW. Surgical management of retropharyngeal space infections in children. Laryngoscope. 2001 Aug. 111(8):1413-22. [Medline].

  16. McClay JE, Murray AD, Booth T. Intravenous antibiotic therapy for deep neck abscesses defined by computed tomography. Arch Otolaryngol Head Neck Surg. 2003 Nov. 129(11):1207-12. [Medline].

  17. Wong DK, Brown C, Mills N, Spielmann P, Neeff M. To drain or not to drain - management of pediatric deep neck abscesses: a case-control study. Int J Pediatr Otorhinolaryngol. 2012 Dec. 76(12):1810-3. [Medline].

  18. Johnston D, Schmidt R, Barth P. Parapharyngeal and retropharyngeal infections in children: argument for a trial of medical therapy and intraoral drainage for medical treatment failures. Int J Pediatr Otorhinolaryngol. 2009 May. 73(5):761-5. [Medline].

  19. Page NC, Bauer EM, Lieu JE. Clinical features and treatment of retropharyngeal abscess in children. Otolaryngol Head Neck Surg. 2008 Mar. 138(3):300-6. [Medline].

  20. Suryadevara AC, Kellman RM. Incision and drainage of a retropharyngeal abscess located adjacent to C1 with InstaTrak image guidance. Laryngoscope. 2006 Mar. 116(3):499-501. [Medline].

  21. Vieira F, Allen SM, Stocks RM, Thompson JW. Deep neck infection. Otolaryngol Clin North Am. 2008 Jun. 41(3):459-83, vii. [Medline].

Previous
Next
 
Schematic of anatomy of deep spaces of neck, as illustrated in lateral and cross-sectional views. Fascial planes (see color key) surround potential spaces. Anteriorly, retropharyngeal space is bounded by buccal pharyngeal fascia, which invests pharynx, trachea, esophagus, and thyroid; posteriorly, by alar fascia; and laterally, by carotid sheaths and parapharyngeal spaces. Retropharyngeal space extends from base of skull to mediastinum at level of tracheal bifurcation. Note danger space located between alar fascia and prevertebral fascia.
Plain film soft tissue views of lateral neck. Top radiograph reveals widening of soft tissues, with anterior displacement of airway. Careful examination of this film reveals gas in soft tissue. Bottom radiograph is much more subtle. Soft tissue is widened at level of C2.
Contrast axial CT scan demonstrates left-side retropharyngeal abscess.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.