Neck Space Infections Flashcards
What is a reteropharyngeal abscess?
Anterior to the prevertebral fascia, behind pharynx, is potential space- reteropharyngeal sapve- abscess may form.
Extends from skull to mediastinum
Clinical features of retropharyngeal abscess?
Commonly in young kids- after URTI
Neck held rigid and upright with reluctance to move
Systemically unwell
Airway compromise
Dysphagia/odynophagia
Widening of the retropharyngeal space on lateral xray
Complications of retropharyngeal abscess?
Associated mortality due to airway problems and mediastinitis
Investigations of retropharyngeal abscess?
CT Neck
Management of retropharyngeal abscess?
Secure airway if any concerns
IV abx
Surgery- I&D
What is Ludwigs Angina?
Infection of the space between the floor of the mouth and mylohyoid, commonly associated with dental infection
Clincal features of Ludwig’s Angina?
Swelling of the floor of the mouth
Painful mouth
Protruding tongue
Airway compromise
Drooling
Investigations for Ludwigs Angina?
CT neck
OPG (scan of upper and lower jaw)
Management of Ludwig’s Angina?
Secure airway if any concerns
IV abx
Surgery to drain any collection
What is a Parapharyngeal abscess?
Potential space postero-lateral to the oropharynx and nasopharynx which is divided by the styloid process
May present similar to ‘quinsy’
Presentation of Parapharyngeal abscess?
Hx of febrile disease
Odynophagia
Trismus
Reduced neck movement
swelling in the neck around upper part of SM
Complications of Parapharyngeal abscess?
The parapharyngeal space contains the carotid sheath–> risk of complications here
Management of parapharyngeal absecess?
Secure airway if concerns
IV abx
Surgical drainage
Who gets Epiglottitis?
Mainly seen in kids 2-6 y/o
EMERGENCY
Cause of Epiglottitis?
Haemophilius Influenzae
Incidence reduced with HIB vaccine
Presentation of Epiglottitis?
Stridor
Drooling
Pyrexia
‘sniffing position’ to maintain airway
RAPIDLY PROGRESSING
Management of Epiglottitis?
Secure the airway- do NOT exam and keep pt calm and with parents as do not want airway compromise
Take child to theatre to be intubated by paeds anaesthetist with ENT surgeon on standby if not possible, intubate in A&E
IV abx- usually respond after a few days and then can be extubated
