Deep Neck Infections Flashcards
Where is a retropharyngeal abscess located?
Anterior to the prevertebral fascia, behind the pharynx, is a potential space, the retropharyngeal space, where an abscess may form. This space extends from the base of the skull to the mediastinum.
What are the clinical features of a retropharyngeal abscess?
Commonly in young children
Commonly after an URTI
Neck held rigid and upright with reluctance to move
Systemically unwell
Airway compromise
Dysphagia/Odynophagia
Widening of the retropharyngeal space on lateral X-Ray
Associated mortality due to airway problems & mediastinitis
How should a suspected retropharyngeal abscess be investigated?
CT Neck
Routine bloods
How are retropharyngeal abscesses managed?
Secure airway if any concerns
IV antibiotics
Surgery - Incision & drainage
What is Lugwig’s angina
Infection of the space between the floor of the mouth and mylohyoid, most commonly associated with dental infection.
What are the clinical features of ludwig’s angina?
Swelling of the floor of the mouth Painful mouth Protruding tongue Airway compromise Drooling
How should Ludwig’s angina be investigated?
CT neck
OPG – orthopantomography -X-ray of the jawline
How is Ludwig’s angina managed?
Secure airway if any concerns
IV antibiotics
Surgery to drain any collection
What is a parapharyngeal abscess?
The parapharyngeal space is a potential space postero-lateral to the oropharynx and nasopharynx which is divided by the styloid process. Parapharyngeal abscesses may present in a similar manner to peritonsillar abscesses or “quinsy”.
What are the clinical features of a parapharyngeal abscess?
There is typically a history of febrile illness, odynophagia, trismus, reduced neck movement and a swelling in the neck around the upper part of the sternocleidomastoid. The parapharyngeal space contains the carotid sheath, and there is therefore the risk of severe complications in this area.
How should parapharyngel abscess be managed?
Secure airway if any concerns
IV Antibiotics
Surgical drainage
