Acute Sore Throat? Think Retropharyngeal Abscess

T., 55 years old, choked on a fish bone while eating. After 2 days, she was admitted to the ENT clinic with complaints of sore throat, hoarseness, sharp difficulty in swallowing and breathing. The general condition of the patient is severe, the neck is enlarged due to edema of soft tissues, the skin is pale, on the anterior surface of the chest there are massive subcutaneous hemorrhages. The patient retains a forced position, cannot lie on the couch on her own. Palpation of the neck and interscapular region causes severe pain. Temperature 39.3 .

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Retropharyngeal Abscess

Hong Kong Journal of Emergency Medicine ◽

10.1177/102490790200900310 ◽

2002 ◽

Vol 9 (3) ◽

pp. 165-167 ◽

Cited By ~ 2

Author(s):

FKC Chu

Keyword(s):

Case Report ◽

Sore Throat ◽

Retropharyngeal Abscess ◽

Adult Case

Retropharyngeal abscess is a condition commonly seen in children but not so common in adult. In this case report, we describe an adult case of retropharyngeal abscess who presented to us with symptoms of sore throat and dysphagia for 1 month.

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Differential diagnosis and effective therapy for sore throat

Medical Council ◽

10.21518/2079-701x-2021-18-166-171 ◽

2021 ◽

pp. 166-171

Author(s):

A. L. Guseva ◽

M. L. Derbeneva

Keyword(s):

Differential Diagnosis ◽

Antibiotic Therapy ◽

Sore Throat ◽

Surgical Intervention ◽

Streptococcal Pharyngitis ◽

Retropharyngeal Abscess ◽

Jugular Vein Thrombosis ◽

Adequate Treatment ◽

Vein Thrombosis ◽

Life Threatening

Sore throat is a common complaint, which can be caused by a typical viral pharyngitis, or it can be rooted in a life-threatening disease such as epiglottitis or inflammation of the cellular spaces in the throat and neck. The doctor should take a closer look at a patient with a sore throat, immediately make a differential diagnosis and prescribe adequate treatment, including surgical intervention, if necessary.The article discusses the most common causes of a sore throat, including various types of pharyngitis, paratonsillar abscess, parapharyngeal abscess, retropharyngeal abscess, epiglottitis.Viral pharyngitis has a favourable prognosis, resolves without intervention and complications, but bacterial and fungal pharyngitis have a more severe course. Streptococcal pharyngitis caused by group A в-hemolytic streptococcus holds a dominant position in bacterial etiology and requires the use of antibiotic therapy. The differential diagnosis of streptococcal pharyngitis is based on the modified Centor scores in the routine clinical practice. Antibiotic therapy for streptococcal pharyngitis includes a 10-day course of unprotected penicillins. If a patient has an allergic reaction to penicillins, it is recommended to use clindamycin or clarithromycin. The surgical intervention combined with intramuscular or intravenous antibiotic therapy is recommended for the treatment of purulent processes in the cellular spaces of the neck. These diseases can have life-threatening complications, which include neurological damage, the spread of purulent process in the mediastinum with the development of mediastinitis, laryn-geal stenosis, sepsis, necrotizing fasciitis, jugular vein thrombosis and erosion of the carotid artery. The third generation cephalosporins and protected penicillins are recommended for the treatment of epiglottitis, and respiratory fluoroquinolones are used, if a patient has a history of allergic reactions to penicillins. In severe cases with symptoms of stenosis, intubation can be performed in addition to the use of antibiotics.

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Adult Retropharyngeal Abscess: A Retrospective Case Series

Otorhinolaryngology Clinics - An International Journal ◽

10.5005/jp-journals-10003-1202 ◽

2015 ◽

Vol 7 (2) ◽

pp. 100-103

Author(s):

Naveen Kumar

Keyword(s):

Lymph Nodes ◽

Sore Throat ◽

Case Series ◽

Retropharyngeal Abscess ◽

Esophageal Wall ◽

Retropharyngeal Space ◽

Retrospective Case ◽

X Ray ◽

Presenting Symptoms ◽

Retrospective Case Series

ABSTRACT Introduction Retropharyngeal abscess (RPA), is a deep tissue neck infection. It is a serious and occasionally life-threatening infection due to the anatomic location and the potential for obstruction of the upper airway. The retropharyngeal space is found posterior to the esophageal wall and anterior to the prevertebral fascia. Lymph nodes found in this space drain the nasopharynx, paranasal sinuses and middle ear. Often infections of these areas will lead to infection in the retropharyngeal space. Atrophy of these lymph nodes at or before puberty has been found as an explanation of the predominance of RPAs in young children. In fact, some believe that they atrophy after 4 years of age. Once almost exclusively a disease of children, is observed with increasing frequency in adults. Retropharyngeal abscess poses a diagnostic challenge for the ENT surgeon because of its infrequent occurrence and variable presentation. Materials and methods Ten cases of adult retropharyngeal abscess were reviewed. The diagnostic criteria were radiological evidence of widening of pre-vertebral soft tissue shadow and presence of pus in the swelling. Results Sore throat, fever, muffled speech, painful swallow and stiffness of the neck were common presenting symptoms. Lateral X-ray of the neck was diagnostic. Commonest organism isolated was Streptococcus pyogenes. Airway obstruction was the commonest complication. Discussion Most of the patients had history of trauma prior to the development of RPA. Computed tomography (CT) scan of neck and thorax has an important role in planning the management in addition to lateral X-ray of the neck. Transoral surgical drainage in association with antibiotics is the treatment of choice in abscesses confined to the retropharyngeal space. Conclusion Tuberculosis is no longer the commonest cause of adult retropharyngeal abscess. Sore throat or dysphagia, disproportionate to clinical findings in the throat should arouse suspicion of RPA. Early intervention with antibiotics reduces the chances of the development of complications. How to cite this article Kumar N. Adult Retropharyngeal Abscess: A Retrospective Case Series. Int J Otorhinolaryngol Clin 2015;7(2):100-103.

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Serious tonsil infections versus tonsillectomy rates in Wales: A 15-year analysis

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2016.0261 ◽

2017 ◽

Vol 99 (1) ◽

pp. 31-36 ◽

Cited By ~ 7

Author(s):

D Yap ◽

AS Harris ◽

J Clarke

Keyword(s):

Sore Throat ◽

Hospital Admissions ◽

Significant Negative Correlation ◽

Peritonsillar Abscess ◽

Significant Rise ◽

Retropharyngeal Abscess ◽

Annual Number ◽

Recurrent Tonsillitis ◽

Parapharyngeal Abscess ◽

Acute Hospitals

INTRODUCTION Sore throat and tonsillitis place a significant burden on the National Health Service. National guideline criteria for gauging the severity of sore throat and tonsillitis have reduced the number of tonsillectomies performed, which is thought to have increased the rate of tonsil-related infections. METHODS Data was extracted from the prospective Patient Episode Database of Wales and analysed to determine the annual number of tonsillectomies for recurrent tonsillitis, adjusted for population changes. Admissions to acute hospitals for tonsillitis, peritonsillar abscess and deep neck space abscesses were also examined. RESULTS Between 1999 and 2014, hospital admissions for tonsillitis rose three-fold (r=0.968), while admissions for peritonsillar abscess rose by 48% (r=0.857) and retro or parapharyngeal abscess admissions also increased (r=0.709). In contrast, the number of tonsillectomies per 100,000 population gradually decreased (r=-0.16). There was a positive correlation between the incidence of tonsillitis and admissions for peritonsillar abscess (adjusted r2 0.631; p=0.015) and retropharyngeal abscess (adjusted r2 0.442; p=0.00254). There was a statistically significant negative correlation between the incidence of tonsillitis and the number of tonsillectomies performed (adjusted r2=-0.07; p=0.0235). CONCLUSIONS The significant rise in tonsillitis in Wales raises the question as to whether we should revisit the criteria for tonsillectomy. The perceived cost saving from limiting certain procedures should not prevent healthcare policymakers from considering all other evidence. The rise in peritonsillar, retropharyngeal and parapharyngeal abscess is alarming, as they are associated with significant morbidity and mortality.

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Don't Rule Out Retropharyngeal Abscess in Sore Throats

Pediatric News ◽

10.1016/s0031-398x(08)70117-6 ◽

2008 ◽

Vol 42 (3) ◽

pp. 16

Author(s):

HEIDI SPLETE

Keyword(s):

Retropharyngeal Abscess ◽

Rule Out

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Lidocaine as Endotracheal Tube Cuff Inflating Agent

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v5i1.2847 ◽

1970 ◽

Vol 5 (1) ◽

pp. 25-28

Author(s):

Nadeem Parvez Ali ◽

Md Tauhid-ul-Mulck ◽

Mahbub Noor ◽

Md Torab Mollick ◽

Masud Ahmed ◽

...

Keyword(s):

Endotracheal Tube ◽

Sore Throat ◽

Distilled Water ◽

Endotracheal Tube Cuff ◽

Postoperative Sore Throat ◽

Lidocaine Group ◽

Entire Study ◽

Tube Cuff ◽

Water Group ◽

A Prospective Study

A prospective study was carried on 120 patients undergoing surgical operations lasting less than 90 minutes. The incidence of postoperative sore throat, dysphasia and hoarseness of voice with 2% lidocaine (Group L) as endotracheal cuff inflating agent was compared with that with distilled water (Group D) and air (Group A). Seventy two percent of lidocaine group in comparison to 60% distilled water group and 37% air group experienced none of the above complications during the entire study period. Only 5% in lidocaine group had sore throat after 22-24 hours compared to 20% in the distilled water group and 45% in the air group. Twenty three percent complained of dysphasia in both lidocaine and distilled water group after 1-3 hours compared to 45% in air group. After 22-24 hours it completely resolved in lidocaine group compared to 20% persisting in the other two groups. Twenty three percent complained of hoarseness in lidocaine group as compared to 35% and 55% in distilled water and air groups respectively after 1-3 hours. This completely resolved in lidocaine group but persisted in 20% and 45% in the distilled water and air group respectively after 22-24 hours. The results showed an advantage in using lidocaine as an endotracheal tube cuff inflating agent in reducing postoperative sore throat, dysphasia and hoarseness in comparison to distilled water and air. Key Words: Lidocain, Endotracheal tube (ETT) cuff inflating agent. doi: 10.3329/jafmc.v5i1.2847 JAFMC Bangladesh. Vol 5, No 1 (June) 2009 pp.25-28

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