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CASE REPORT
Life-threatening parapharyngeal and retropharyngeal abscess in an infant
  1. Anusha Balasubramanian1,2,
  2. J Redzwan Shah1,
  3. Norzi Gazali2,
  4. Philip Rajan1
  1. 1Department of Otorhinolaryngology, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia
  2. 2Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
  1. Correspondence to Dr Anusha Balasubramanian, aansangel{at}yahoo.com

Summary

Severe extensive deep neck abscess in an infant is uncommon. We share the case of a previously well 4-month old infant who was referred for a 4-day history of fever, lethargy and left lateral neck swelling. Contrast-enhanced CT scan revealed a large 5.3×8 cm collection involving the left parapharyngeal and retropharyngeal space, causing significant airway narrowing. 40 mL of frank pus was drained via intraoral incision and drainage with the aid of endoscope, and undesirable complications from an external approach were averted. The infant was extubated 48 hours postsurgery and was discharged home well after completion of 1 week of intravenous antibiotics. The child was discharged well from our follow-up at 1 month review. We discuss the pathophysiology of deep neck space abscesses, its incidence in the paediatric population and the various management options.

  • ear, nose and throat/otolaryngology
  • paediatric intensive care
  • otolaryngology / ent
  • paediatric surgery
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Footnotes

  • Contributors AB: conception and design of the work, the acquisition, analysis or interpretation of data; drafting the work or revising it critically for important intellectual content; agreement to be accountable for all aspects of the work. JRS: drafting the work or revising it critically for important intellectual content; agreement to be accountable for all aspects of the work. NG: revising critically and final approval of the version published; agreement to be accountable for all aspects of the work. PR: revising critically and final approval of the version published; agreement to be accountable for all aspects of the work.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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