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Retropharyngeal abscess — RCPSC EM MCQ

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ModeratePaediatric emergenciesRetropharyngeal abscessRCPSC EM

A 7-year-old has fever, sore throat, drooling, muffled voice and neck stiffness. He is unimmunised and appears toxic. Lateral neck radiograph shows widened prevertebral soft tissue and CT is deferred because he cannot lie flat. What is the most likely diagnosis?

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Correct answer: D — Retropharyngeal abscess

Toxic appearance, drooling, muffled voice, neck stiffness and widened prevertebral tissues suggest retropharyngeal abscess. Airway planning, IV antibiotics and ENT involvement are needed.

Reference: Canadian Paediatric Society deep neck infection principles; PALS