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Pediatrik Dev Retrofarengeal Abse (İnsidental tanı)

Year 2025, Volume: 10 Issue: 2, 53 - 55, 31.08.2025

Abstract

Retrofarengeal abseler, özellikle pediatrik yaş grubunda ve çoğunlukla 4 yaş altındaki çocuklarda görülen,
nadir fakat ciddi komplikasyonlara yol açabilen derin boyun enfeksiyonlarıdır. Semptomların silik olması
ve fizik muayenede patolojik bulguların belirgin olmaması, tanının gecikmesine neden olabilmektedir. Bu olgu
sunumunda, 7 aylık bir erkek hastada bronşiolit ön tanısıyla takip edilirken, yoğun bakım sürecinde internal
juguler kateterizasyonu sırasında fark edilen boyun bölgesinden püy gelişi sonrası görüntüleme ile tanı alan
dev retrofarengeal abse vakası sunulmuştur. Hastaya kontrastlı bilgisayarlı tomografi ile tanı konmuş, ardından
cerrahi drenaj uygulanmıştır. Postoperatif süreçte antibiyotik tedavisi ile klinik iyileşme sağlanmış ve hasta
taburcu edilmiştir. Bu vaka, pediatrik yaş grubunda retrofarengeal abselerin ayırıcı tanıda akılda tutulması
gerektiğini ve klinik şüphe durumunda görüntüleme yöntemlerinden kaçınılmaması gerektiğini vurgulamaktadır.

References

  • 1. Davis WL, Harnsberger HR, Smoker WR, Watanabe AS. Retropharyngeal space: evaluation of normal anatomy and diseases with CT and MR imaging. Radiology. 1990;174(1):59-64.
  • 2. Weiner KAS, Rieger CC, Wohl DL, Harley EH. Retropharyngeal abscess with mediastinal extension: a case series and review of the literature. Ear Nose Throat J. 2023;102(9):580-583.
  • 3. Shah RK, Chun R, Choi SS. Mediastinitis in infants from deep neck space infections. Otolaryngol Head Neck Surg. 2009;140(6):936- 938.
  • 4. Adil E, Tarshish Y, Roberson D, Jang J, Licameli G, Kenna M. The public health impact of pediatric deep neck space infections. Otolaryngol Head Neck Surg. 2015;153(6):1036-1041.
  • 5. Craig FW, Schunk JE. Retropharyngeal abscess in children: clinical presentation, utility of imaging, and current management. Pediatrics. 2003;111(6):1394-1398.
  • 6. Hoffmann C, Pierrot S, Contencin P, Morisseau-Durand MP, Manach Y, Couloigner V. Retropharyngeal infections in children: treatment strategies and outcomes. Int J Pediatr Otorhinolaryngol. 2011;75(9):1099-1103.
  • 7. Saluja S, Brietzke SE, Egan KK, Klavon S, Robson CD, Waltzman ML, et al. A prospective study of 113 deep neck infections managed using a clinical practice guideline. Laryngoscope. 2013;123(12):3211-3218.
  • 8. Poe LB, Manzione JV, Wasenko JJ, Kellman RM. Acute internal jugular vein thrombosis associated with pseudoabscess of the retropharyngeal space. Am J Neuroradiol. 1995;16(4):892-896.
  • 9. Sato K, Izumi T, Toshima M, Nagai T, Muroi K, Komatsu N, et al. Retropharyngeal abscess due to methicillin-resistant Staphylococcus aureus in a case of acute myeloid leukemia. Intern Med. 2005;44(4):346-349.
  • 10. Morrison JE Jr, Pashley NR. Retropharyngeal abscesses in children: a 10-year review. Pediatr Emerg Care. 1988;4(1):9-11.
  • 11. Allotey J, Duncan H, Williams H. Mediastinitis and retropharyngeal abscess following delayed diagnosis of glass ingestion. Emerg Med J. 2006;23(2):e12.
  • 12. Reilly BK, Reilly JS. Retropharyngeal abscess: diagnosis and treatment update. Infect Disord Drug Targets. 2012;12(4):291-296.
  • 13. 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;74(9):1016-1020.

Pediatric Giant Retropharyngeal Abscess: An Incidental Diagnosis

Year 2025, Volume: 10 Issue: 2, 53 - 55, 31.08.2025

Abstract

Retropharyngeal abscesses are rare but potentially serious deep neck infections, particularly seen in the pediatric
population, most commonly in children under the age of four. The nonspecific nature of symptoms and the absence
of evident findings on physical examination often lead to delayed diagnosis. In this case report, we present a
7-month-old male infant who was initially followed with a presumptive diagnosis of bronchiolitis. During the
intensive care follow-up, purulent discharge observed at the site of internal jugular catheterization prompted
further evaluation, leading to the diagnosis of a large retropharyngeal abscess through imaging. The diagnosis
was confirmed with contrast-enhanced computed tomography, and surgical drainage was subsequently performed.
Clinical improvement was achieved postoperatively with antibiotic therapy, and the patient was discharged in
good condition. This case highlights the importance of considering retropharyngeal abscesses in the differential
diagnosis in pediatric patients and emphasizes the necessity of early imaging in cases of clinical suspicion.

References

  • 1. Davis WL, Harnsberger HR, Smoker WR, Watanabe AS. Retropharyngeal space: evaluation of normal anatomy and diseases with CT and MR imaging. Radiology. 1990;174(1):59-64.
  • 2. Weiner KAS, Rieger CC, Wohl DL, Harley EH. Retropharyngeal abscess with mediastinal extension: a case series and review of the literature. Ear Nose Throat J. 2023;102(9):580-583.
  • 3. Shah RK, Chun R, Choi SS. Mediastinitis in infants from deep neck space infections. Otolaryngol Head Neck Surg. 2009;140(6):936- 938.
  • 4. Adil E, Tarshish Y, Roberson D, Jang J, Licameli G, Kenna M. The public health impact of pediatric deep neck space infections. Otolaryngol Head Neck Surg. 2015;153(6):1036-1041.
  • 5. Craig FW, Schunk JE. Retropharyngeal abscess in children: clinical presentation, utility of imaging, and current management. Pediatrics. 2003;111(6):1394-1398.
  • 6. Hoffmann C, Pierrot S, Contencin P, Morisseau-Durand MP, Manach Y, Couloigner V. Retropharyngeal infections in children: treatment strategies and outcomes. Int J Pediatr Otorhinolaryngol. 2011;75(9):1099-1103.
  • 7. Saluja S, Brietzke SE, Egan KK, Klavon S, Robson CD, Waltzman ML, et al. A prospective study of 113 deep neck infections managed using a clinical practice guideline. Laryngoscope. 2013;123(12):3211-3218.
  • 8. Poe LB, Manzione JV, Wasenko JJ, Kellman RM. Acute internal jugular vein thrombosis associated with pseudoabscess of the retropharyngeal space. Am J Neuroradiol. 1995;16(4):892-896.
  • 9. Sato K, Izumi T, Toshima M, Nagai T, Muroi K, Komatsu N, et al. Retropharyngeal abscess due to methicillin-resistant Staphylococcus aureus in a case of acute myeloid leukemia. Intern Med. 2005;44(4):346-349.
  • 10. Morrison JE Jr, Pashley NR. Retropharyngeal abscesses in children: a 10-year review. Pediatr Emerg Care. 1988;4(1):9-11.
  • 11. Allotey J, Duncan H, Williams H. Mediastinitis and retropharyngeal abscess following delayed diagnosis of glass ingestion. Emerg Med J. 2006;23(2):e12.
  • 12. Reilly BK, Reilly JS. Retropharyngeal abscess: diagnosis and treatment update. Infect Disord Drug Targets. 2012;12(4):291-296.
  • 13. 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;74(9):1016-1020.
There are 13 citations in total.

Details

Primary Language Turkish
Subjects Otorhinolaryngology
Journal Section Olgu Sunumu
Authors

Nuri Ünsal 0000-0002-5247-5345

Altan Kaya 0000-0001-8918-9054

Serap Bulut Çöbden 0000-0002-4471-1934

Yunus Kantekin 0000-0003-4332-725X

Ali Bayram 0000-0002-0061-1755

Mehmet Yaşar 0000-0002-8246-6853

Publication Date August 31, 2025
Submission Date December 4, 2024
Acceptance Date April 23, 2025
Published in Issue Year 2025 Volume: 10 Issue: 2

Cite

Vancouver Ünsal N, Kaya A, Bulut Çöbden S, Kantekin Y, Bayram A, Yaşar M. Pediatrik Dev Retrofarengeal Abse (İnsidental tanı). JAMER. 2025;10(2):53-5.