Anti-Bacterial Agents/therapeutic use* ; Consensus ; Drainage ; Humans ; Neck ; Retropharyngeal Abscess ; Retrospective Studies

Brain Diseases ; Child ; Humans ; Neck ; Retropharyngeal Abscess

Tuberculous spondylitis, also known as Pott's disease, is a disease involving the spine with progressive destruction. It most commonly involves the thoracic and lumbosacral spine and may result in severe deformity or neurologic deficit. Although cervical spine involvement is rare, it can cause life threatening event. Recently, 70-year-old man presented with progressive dyspnea and dysphagia. Physical examination and radiologic studies showed a huge retropharyngeal abscess with bony erosion and sclerotic change at the adjacent cervical spine. After incision and drainage, it was finally confirmed as a tuberculous abscess. Herein, we report our experience with literature review.
Abscess ; Aged ; Congenital Abnormalities ; Deglutition Disorders ; Drainage ; Dyspnea ; Humans ; Neurologic Manifestations ; Physical Examination ; Retropharyngeal Abscess ; Spine ; Spondylitis ; Tuberculosis ; Tuberculosis, Spinal

Tuberculosis of the retropharynx is extremely rare. The diagnosis is frequently delayed because of its anatomical location and atypical symptom. It would be crucial to consider tuberculosis infection as a possible source of abscess and should be mindful about the tests to diagnose it. We experienced a 23-year-old man with retropharyngeal abscess caused by tuberculosis presenting hypernasality and hoarseness in the throat. In this article, we reviewed the etiology, diagnosis, and treatment of this case, with a review of literatures.
Abscess ; Diagnosis ; Hoarseness ; Humans ; Pharynx ; Retropharyngeal Abscess ; Tuberculosis ; Young Adult

Human actinomycosis with involvement of the spine is a rare condition, with only a limited number of case reports published. To the best of our knowledge, no cases have been reported of epidural abscess causing destruction of the C2 body, bringing about a direct connection between spinal epidural and retropharyngeal abscesses. Here, we present such a case that occurred after acupuncture, and we review the relevant literature.
Abscess ; Actinomycosis* ; Acupuncture ; Epidural Abscess* ; Humans ; Retropharyngeal Abscess* ; Spine

Given that Kawasaki disease (KD) can cause cardiac complications, it is crucial to diagnose and treat the disease in the emergency department. We report a case of a 10-year-old girl who presented to the emergency department with cervical lymphadenopathy and fever. The initial diagnosis was retropharyngeal abscess based on computed tomography findings, but antibiotic therapy failed and she was subsequently diagnosed with KD. After 3 doses of intravenous immunoglobulin along with methylprednisolone and methotrexate, she was discharged on hospital day 21. The cervical lymphadenopathy suggesting retropharyngeal abscess might be an early sign of incomplete or intravenous immunoglobulin-resistant KD.
Child* ; Diagnosis* ; Emergency Service, Hospital ; Female* ; Fever* ; Humans ; Immunoglobulins ; Lymphatic Diseases* ; Methotrexate ; Methylprednisolone ; Mucocutaneous Lymph Node Syndrome* ; Neck Pain ; Retropharyngeal Abscess* ; Vasculitis

Deep neck infection is a surgical emergency that can result in life threatening complications such as airway obstruction, aspiration, thrombosis of major vessels and mediastinitis by spread of infection along fascial planes. Although appropriate surgical intervention and prompt antibiotics are given, revision surgeries are often required. We report a patient with mediastinal abscess caused by a deep neck infection that was initially intractable with usual surgical drainage but was eventually successfully treated with the modified application of a vacuum-assisted closure (VAC) device (InfoV.A.C. Therapy Unit; Kinetic Concept Inc., USA). We inserted silastic drain tubes into paratracheal area. It was difficult to pack the VAC foams, so they were prone to fail, with complete debridement. With modified VAC therapy assisted by silastic drain tube, the deeply located mediastinal abscess that had been unresponsive to conventional surgical drainage was successfully treated.
Abscess* ; Airway Obstruction ; Anti-Bacterial Agents ; Debridement ; Drainage ; Emergencies ; Humans ; Mediastinitis ; Neck* ; Negative-Pressure Wound Therapy* ; Retropharyngeal Abscess ; Thrombosis

The authors report the clinical features of huge retropharyngeal cyst, which was confirmed as tubercular abscess, in a 24-year-old woman. Retropharyngeal tuberculosis is a rare type of disease and only four cases have been reported in Korea. In this case, the patient experienced foreign body sensation and hoarseness in the throat. On endoscopic examination and computed tomography, a cyst-like lesion which narrowed the oropharynx was shown in the left retropharyngeal space. The patient was successfully treated with surgical drainage and anti-tubercular therapy.
Abscess ; Drainage ; Female ; Foreign Bodies ; Hoarseness ; Humans ; Korea ; Oropharynx ; Pharynx ; Retropharyngeal Abscess ; Sensation ; Tuberculosis* ; Young Adult

Neck mass can be frequently encountered in pediatric patients. Most neck mass in pediatric patients are either inflammatory lesions or benign tumors but their differential diagnoses are not always easy. We must not forget the study results that a considerable portion of pediatric neck mass constitutes malignant tumors. Generally neck mass can be divided into inflammatory, developmental (congenital), and tumorous lesions. Developmental neck mass are generally thyroglossal duct cyst, branchial cleft cyst, dermoid cyst, vascular malformation, or hemangioma. Manifestations of inflammatory neck mass are reactive cervical lymphadenopathy, infectious lymphadenitis (viral or bacterial), mycobacterial cervical lymphadenopathy, or Kawasaki disease. The more uncommonly found pediatric malignant neck mass are lymphoma, rhabdomyosarcoma, or thyroid carcinoma. For the diagnosis of pediatric neck mass complete blood count, purified protein derivative test for tuberculosis, and measurement of titers for Epstein-Barr virus are required and in special cases, infectious diagnostic panels for cat-scratch disease, cytomegalovirus, human immunodeficiency virus, or toxoplasmosis may be needed. Ultrasonography is the most convenient and feasible diagnostic method in differentiating various neck mass. Computed tomography is performed when identifying the anatomical aspects of the neck mass or where deep neck infection or retropharyngeal abscess is suspected. Surgical management for congenital neck mass is recommended to prevent secondary infection or various complications following size increase. Most pediatric neck mass originate from bacterial lymphadenitis and antibacterial therapy is considered first line of conservative treatment. However if the neck mass is either over 2 cm in size without any evidence of inflammation, firm or fixed to surrounding tissue, accompanied by B symptoms, unresponsive to initial antibacterial therapy or over 4 weeks of conservative management, or considered keep growing for over 2 weeks, one must suspect the possibility of malignancy and must consult a head and neck specialist for further detailed evaluation.
Blood Cell Count ; Branchioma ; Cat-Scratch Disease ; Coinfection ; Cytomegalovirus ; Dermoid Cyst ; Diagnosis ; Diagnosis, Differential ; Head ; Hemangioma ; Herpesvirus 4, Human ; HIV ; Humans ; Inflammation ; Lymphadenitis ; Lymphatic Diseases ; Lymphoma ; Mucocutaneous Lymph Node Syndrome ; Neck* ; Retropharyngeal Abscess ; Rhabdomyosarcoma ; Specialization ; Thyroglossal Cyst ; Thyroid Neoplasms ; Toxoplasmosis ; Tuberculosis ; Ultrasonography ; Vascular Malformations

The authors report the clinical features of a huge retropharyngeal second branchial cyst in a 53-year-old woman. The patient showed acute exacerbation of dyspnea and dysphagia. On endoscopic examination and computed tomography (CT), a cyst-like lesion narrowing the oropharynx was observed in the right retropharyngeal space. However, a retropharyngeal abscess was also suspected on some CT images. A cystic mass was found and removed completely via exploration by trans-oral approach. According to the literature review, a branchial cleft anomaly mimicking retropharyngeal abscess is very rare.
Branchial Region ; Branchioma* ; Deglutition Disorders* ; Dyspnea* ; Female ; Humans ; Middle Aged ; Oropharynx ; Pharynx ; Retropharyngeal Abscess