scholarly journals Acute retropharyngeal abscess in adults: a case series

2016 ◽  
Vol 3 (1) ◽  
pp. 151 ◽  
Author(s):  
Inderdeep Singh ◽  
Vikas Gupta ◽  
Sunil Goyal ◽  
Manoj Kumar ◽  
Lakshmi Ranjit ◽  
...  
Keyword(s):  
Foreign Bodies ◽  
Case Series ◽  
Retropharyngeal Abscess ◽  
Retropharyngeal Space ◽  
Surgical Drainage ◽  
Deep Neck Space Infections ◽  
Primary Focus ◽  
High Index Of Suspicion ◽  
Dental Infections ◽  
Primary Modality

<p>Retropharyngeal abscesses are uncommon but potentially lethal infections. In the adult group they are usually secondary to trauma, foreign bodies, or as a complication of dental infections. Early diagnosis and the wide spread use of antibiotics have made these infections less common today. High index of suspicion and clinical acumen is required to provisionally diagnose these cases. In the current era where empirical use of high end and advanced antibiotics is prevalent it is not surprising to find patients with highly resistant microbes, such cases present further difficulty to treat. For large retropharyngeal abscesses, surgical drainage remains the primary modality followed by aggressive targeted antibiotic therapy. We present three cases of deep neck space infections with primary focus in retropharyngeal space. All required surgical drainage and aggressive postoperative care. Extensive review of literature of retropharyngeal abscess in adults was done to derive characterizations about this disease. </p>

Retropharyngeal abscess: a clinical review

1997 ◽  
Vol 111 (6) ◽  
pp. 546-550 ◽  
Author(s):  
D. Goldenberg ◽  
A. Golz ◽  
H. Z. Joachims
Keyword(s):  
Foreign Bodies ◽  
Secondary Trauma ◽  
Respiratory Infections ◽  
Paediatric Population ◽  
Retropharyngeal Abscess ◽  
Surgical Drainage ◽  
Important Diagnostic Tool ◽  
Anatomical Localization ◽  
Upper Respiratory ◽  
Dental Infections

AbstractRetropharyngeal abscesses are uncommon but potentially lethal infections, especially in the paediatric population under the age of five years. Abscesses in this group are classically secondary to upper respiratory infections especially oropharyngeal infections, while in the adult group they are usually secondary to trauma, foreign bodies, or as a complication of dental infections. Early diagnosis and the wide spread use of antibiotics have made these infections less common today. Between the years 1985–1996,19 cases of retropharyngeal abscesses were treated in our department. Factors such as age, sex, aetiology, presenting signs, symptoms, methods of diagnosis, treatment and complications were reviewed. Thirty-two per cent of the cases were secondary trauma. A lateral neck film showing widening of the prevertebral space was the most important diagnostic tool, computed tomography (CT) scan was used in 63 per cent of cases to verify the signs of an abscess and to provide more accurate anatomical localization.Thirteen cases required surgical drainage. The single most commonly isolated pathogen wasStreptococcus pyogenes. There were no deaths and only one recurrence requiring repeated surgical drainage. One case was complicated by a spinal canal abscess. We also report two cases of retropharyngeal abscess in children caused by swallowing of unusual foreign bodies.

scholarly journals Adult Retropharyngeal Abscess: A Retrospective Case Series

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.

Internal drainage of retropharyngeal abscess secondary to esophageal foreign bodies: a case series

2021 ◽  
Author(s):  
Aparna Das ◽  
Karthikeyan Ramasamy ◽  
Saranya Thangavel ◽  
Rashmi Hansdah ◽  
Arun Alexander ◽  
...  
Keyword(s):  
Foreign Bodies ◽  
Case Series ◽  
Retropharyngeal Abscess ◽  
Internal Drainage ◽  
Esophageal Foreign Bodies

Pyopneumothorax—a rare sequelae of retropharyngeal abscess

1993 ◽  
Vol 107 (5) ◽  
pp. 460-462 ◽  
Author(s):  
S. Lokman ◽  
A. Sani ◽  
D. S. Sidek
Keyword(s):  
Foreign Bodies ◽  
Fish Bone ◽  
Retropharyngeal Abscess ◽  
Retropharyngeal Space ◽  
Fatal Complication ◽  
Initial Attempt

A case of massive pyopneumothorax as a rare sequelae of retropharyngeal abscess following fish bone ingestion is reported. An initial attempt at removal of the fish bone in the oesophagus using the fibroptic oesophagoscope was unsuccessful, causing failure of its removal and the development of this rare and potentially fatal complication. The intercommunication of the retropharyngeal space with other spaces of the neck and thorax that allow this and most other complications to occur is described. Rigid endoscopes are the instrument of choice in retrieving sharp foreign bodies in the oesophagus.

scholarly journals Rhinolith a forgotten entity: our experience in remote hilly population of Uttarakhand

2018 ◽  
Vol 4 (2) ◽  
pp. 508
Author(s):  
Chetan Bansal ◽  
V. P. Singh ◽  
Deeksha Nautiyal
Keyword(s):  
Nasal Obstruction ◽  
Foreign Bodies ◽  
Early Stage ◽  
Case Series ◽  
Diagnostic Techniques ◽  
Open Approach ◽  
Rare Occurrence ◽  
Nasal Symptoms ◽  
Nasal Bleeding ◽  
High Index Of Suspicion

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Rhinoliths are mineralized foreign bodies in the nasal cavity and are diagnosed based on the presenting illness and clinical examination. Giant nasal stones are very rare in occurrence, since improved diagnostic techniques now make it possible to identify foreign bodies at an early stage of disease. The aim of the study was to revisit this rare and forgotten clinical entity with the variations in presentation in the hilly population of uttarakhand and treatment revisited.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">We report a case series of 33 patients with rhinoliths who presented to our institute over a period of 10 years, from January 2007 to January 2017.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Average age was 25.48 years (range: 5 years to 60 years). 19 were female and 14 male. The incident was reported by a family member/attendant in 12.1% of cases (4 cases), discovered following nasal symptoms in 84.84% (28 cases) and was incidentally discovered in 3.03% (1 case). Symptoms comprised rhinorrhea associated with unpleasant nasal odor in 30.3% of cases (10 cases), epistaxis in 15.1% (5 cases), symptoms of sinusitis in 18.12% (6 cases), ozena in 6% (2 cases)and nasal obstruction in 84.84% (28 cases). There was one case of massive bilateral rhinolith presenting with bilateral symptoms which required an open approach in today’s era whereas all other cases were managed endoscopically. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Although rhinoliths are a rare occurrence, attending doctors should be aware of this entity and should have a high index of suspicion in cases with progressive unilateral nasal obstruction, unilateral rhinorrhea, unilateral nasal bleeding. In rare cases, rhinolith should be kept in mind as a differential diagnosis and also in bilateral nasal symptoms also specially if the symptoms are long standing.</span></p>

Retrospective Review of Management and Outcomes of Pediatric Descending Mediastinitis

2016 ◽  
Vol 155 (1) ◽  
pp. 155-159 ◽  
Author(s):  
Caleb D. Wilson ◽  
Kenneth Kennedy ◽  
Joshua W. Wood ◽  
T. K. Susheel Kumar ◽  
Rose Mary S. Stocks ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Tertiary Care ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Retropharyngeal Abscess ◽  
Surgical Drainage ◽  
Pediatric Hospital ◽  
Source Of Infection ◽  
Successful Approach ◽  
Descending Mediastinitis

Objectives To review the management and outcomes of pediatric patients treated for descending mediastinitis at a single institution and contribute to an updated mortality rate. Study Design Case series with chart review. Setting Tertiary care pediatric hospital. Subjects and Methods This study is a 19-patient case series of all patients treated for descending mediastinitis at a tertiary pediatric hospital from 1997 to 2015, and it serves as an update to the case series published from this institution in 2008. Review of management included time to diagnosis, time to surgery, surgical procedures performed, and antibiotics administered. The primary outcomes measured were length of hospitalization and mortality. Results In addition to 8 previously reported patients, we identified 11 pediatric patients treated for descending mediastinitis in the period of review. All 19 patients were <18 months old, and all survived their hospitalization. Fourteen patients underwent surgical drainage at least twice. The median length of hospital stay was 15 days. Retropharyngeal abscess was the source of infection in 16 of 19 patients, and methicillin-resistant Staphylococcus aureus (MRSA) was the isolated organism in 14 of 15 positive cultures. Conclusion This review represents the largest reported series of pediatric patients with descending mediastinitis. With 100% survival, our results suggest that pediatric descending mediastinitis can be safely managed by prompt surgical drainage. Broad-spectrum antibiotics covering MRSA and a low threshold for repeat surgical intervention have been an important part of our successful approach and may decrease length of stay.

scholarly journals Common upper respiratory tract infection leading to uncommon retropharyngeal abscess - A case series on paediatrics

2020 ◽  
Vol 11 (1) ◽  
pp. 836-839
Author(s):  
Lalduhawmi T C ◽  
Diya C ◽  
Keerthana Arjunan ◽  
Jerlin Anusha R ◽  
Keerthana Chandrasekar
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Oral Hygiene ◽  
Case Series ◽  
Upper Respiratory Tract Infection ◽  
Retropharyngeal Abscess ◽  
Retropharyngeal Space ◽  
Upper Respiratory Tract ◽  
Upper Respiratory

Retropharyngeal abscess is the formation of pus in retropharyngeal space, which occurs as a frequent complication of Upper Respiratory Tract Infection (URI). It is commonly seen in children less than 5 years old. The clinical manifestations includes neck mass, fever, cervical lymphadenopathy, neck stiffness, agitation, cough, drooling, torticollis, respiratory distress, stridor, and with signs of tonsillitis, pharyngitis, and otitis media. The first-line treatment includes drugs such as ampicillin-sulbactam and clindamycin. This case series highlights the complications of untreated upper respiratory tract infection leading to retropharyngeal abscess. Oral hygiene should be maintained to prevent future complications. Two patients were admitted in the paediatric inpatient unit and were diagnosed as a case of retropharyngeal abscess, following for which their management was done. After assessing, the clinical presentations and management scenario of the patients, age, and poor hygienic conditions are associated with the patients' risk factors for acquiring Retropharyngeal Abscess. In paediatrics, maintaining hygiene, especially oral hygiene and early diagnosis can prevent future complications of retropharyngeal abscess.

scholarly journals Retropharyngeal abscess, submandibular abscess, and regio colli abscess with bronchopneumonia in a 2.5-month-old boy

2019 ◽  
Vol 42 (3) ◽  
pp. 137
Author(s):  
Irhamna Yusra ◽  
Finny Fitry Yani
Keyword(s):  
Vertebral Osteomyelitis ◽  
Streptococcal Pharyngitis ◽  
Retropharyngeal Abscess ◽  
Surgical Drainage ◽  
Emergency Case ◽  
Delay In Diagnosis ◽  
Life Threatening ◽  
History Of ◽  
Deep Neck Space Infections ◽  
Disease Specialist

Deep neck space infections (DNSIs) in pediatric require more intimate management because of their rapidly progressive nature. Delay in diagnosis and treatment may lead to life-threatening complications. Objective: To report DNSIs as one of emergency case in children. Early diagnosis and immediate management can decrease morbidity and mortality rate in children. Case: A case of a 2.5-month-old boy with chief complain breathlessness due to deep neck space infections and bronchopneumonia. Patient was getting better after surgical drainage. Conclusions: It most commonly occurs in children younger than four years of age having medical history of streptococcal pharyngitis, rarely as a complication of recent trauma, odontogenic infection or extension of vertebral osteomyelitis. Management often consists of antimicrobial therapy and surgical drainage. With the cooperation of ENT specialist and pediatrician/pediatric infectious disease specialist. Management in PICU is mandatory due to high risk of complications.

scholarly journals Red herring unmasked: the trail leading to retinoblastoma

2021 ◽  
Vol 3 (2) ◽  
pp. 101-106
Author(s):  
Variant Nee Vern Chee ◽  
Li Yen Chan ◽  
Zayani Binti Zohari ◽  
Fazliana Binti Ismail ◽  
Jamalia Binti Rahmat
Keyword(s):  
Anterior Chamber ◽  
Blunt Trauma ◽  
Poor Prognosis ◽  
Foreign Bodies ◽  
Histopathological Examination ◽  
Case Series ◽  
Accurate Diagnosis ◽  
Vitreous Haemorrhage ◽  
History Of ◽  
High Index Of Suspicion

This case series highlights the possibility of retinoblastoma in children with a history of trauma. Retinoblastoma commonly presents with leukocoria. In our series, the history of blunt trauma led to a misdiagnosis. The delay in correctly diagnosing retinoblastoma was made more difficult with hyphaema and vitreous haemorrhage obscuring the fundus view. Hyperdensities in imaging tests were mistaken for intraocular foreign bodies and post-trauma insult rather than calcification of an intraocular tumour. Both patients underwent anterior chamber washout. The patients were referred to our centre when their condition worsened. Retinoblastoma was highly suspected and confirmed from histopathological examination after enucleation. An accurate diagnosis can only be achieved by exercising a high index of suspicion. Misdiagnosis and mismanagement will lead to poor prognosis.

scholarly journals Pancreatico‑pleural Fistula: Case Series

2018 ◽  
Vol 09 (01) ◽  
pp. 026-031 ◽  
Author(s):  
Manoj Munirathinam ◽  
Pugazhendhi Thangavelu ◽  
Ratnakar Kini
Keyword(s):  
Magnetic Resonance ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Case Series ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Fluid Analysis ◽  
High Index Of Suspicion ◽  
Enhanced Computed Tomography ◽  
Acute And Chronic Pancreatitis ◽  
Pancreatic Pathology

ABSTRACTPancreatico‑pleural fistula is a rare but serious complication of acute and chronic pancreatitis. The pleural effusion caused by pancreatico‑pleural fistula is usually massive and recurrent. It is predominately left‑sided but right‑sided and bilateral effusion does occur. We report four cases of pancreatico‑pleural fistula admitted to our hospital. Their clinical presentation and management aspects are discussed. Two patients were managed by pancreatic endotherapy and two patients were managed conservatively. All four patients improved symptomatically and were discharged and are on regular follow‑up. Most of these patients would be evaluated for their breathlessness and pleural effusion delaying the diagnosis of pancreatic pathology and management. Hence, earlier recognition and prompt treatment would help the patients to recover from their illnesses. Pancreatic pleural fistula diagnosis requires a high index of suspicion in patients presenting with chest symptoms or pleural effusion. Extremely high pleural fluid amylase levels are usual but not universally present. A chest X‑ray, pleural fluid analysis, and abdominal imaging (magnetic resonance cholangiopancreatography/magnetic resonance imaging abdomen more useful than contrast‑enhanced computed tomography abdomen) would clinch the diagnosis. Endoscopic retrograde cholangiopancreatography with stent or sphincterotomy should be considered when pancreatic duct (PD) reveals a stricture or when medical management fails in patients with dilated or irregular PD. Surgical intervention may be indicated in patients with complete disruption of PD or multiple strictures.

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