Aetiologies and Management of Retropharyngeal Abscess in Paediatric Age Group

Abstract

Introduction: Retropharyngeal abscess (RPA) is deep neck space infection which requires prompt diagnosis and management due to its potential life-threatening nature. In paediatric group it is most common between 3-5 years of age with infants presenting it very rarely. We are reporting a case series of all the children who were diagnosed of RPA and managed successfully.

Materials and methods: This is a single‑center, retrospective study conducted at the tertiary care hospital. Detailed data from the case files of patients who were diagnosed and managed for RPA from 2012 to 2022 were included. The demographic details, presenting complaints, site of involvement, CT findings, intra-operative findings, pus culture report and course of child during hospitalization was meticulously documented along with their follow up findings and analysed.

Results: Total number of children who underwent treatment for RPA during the study period is 17. maximum number of cases were below 4 years of age accounting for 65%. 58.8 % had an episode of Upper respiratory tract infection before developing the RPA. 2 patients were diagnosed to have tuberculosis and had started on Anti tubercular treatment.  One child had sustained injury to neck, and one had history of chicken bone ingestion. Five children showed the complications of which 60% of them were infant:

Conclusion: The crucial step in infants with RPA is prompt diagnosis and aggressive management. Initial antibiotics should be a broad spectrum until the pus culture sensitivity reports are available. There is a recent trend is Methicillin resistant staphylococcus aureus especially in younger children.  Paradoxical reaction of tubercular treatment is rare and should be borne in mind of its possibilities while treating.