Cases reported "Retropharyngeal Abscess"

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1/36. retropharyngeal abscess: an unusual complication of tracheal intubation.

    A 42-year-old man presented as an emergency to the ENT department with sore throat and complete dysphagia, having undergone an umbilical hernia repair under general anaesthesia with tracheal intubation 3 weeks previously at another institution. One course of antibiotics from his general practitioner improved the symptoms but, on discontinuation of the antibiotics, symptoms flared up leading to complete dysphagia. Indirect laryngoscopy showed a bulging of the retropharyngeal wall, which was confirmed as a widening of the retropharyngeal space on a lateral soft-tissue x-ray film of the neck. Surgical exploration confirmed a retropharyngeal abscess, which probably occurred as a complication of the original tracheal intubation.
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keywords = neck
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2/36. retropharyngeal abscess. A rare presentation of nasopharyngeal carcinoma.

    Early symptoms of nasopharyngeal carcinoma (NPC) can often be deceptive and confusing. Most patients with nasopharyngeal carcinoma present at an advanced stage with metastatic cervical nodes present at the time of diagnosis. A deep neck abscess as the presenting feature has not been reported. We report two cases of nasopharyngeal carcinoma which presented with retropharyngeal abscesses and persistent lymphadenopathy. These two patients illustrate that refractory lymphadenopathy, despite adequate treatment of the associated infection, should prompt a search for underlying disease. The relationship between nasopharyngeal carcinoma and retropharyngeal abscess is discussed.
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3/36. retropharyngeal abscess on a Ga-67 scan: a case report.

    A retropharyngeal abscess is a potentially fatal deep neck infection. Classical symptoms include fever, neck swelling, sore throat, dysphagia, and cervical rigidity. Sometimes small children present with nonspecific symptoms. We report a rare case whereby the Ga-67 citrate scan was the first investigation to reveal an inflammatory process in the retropharyngeal or submastoid region of a 3-year-old child with sepsis. This directed the line of investigation to a more precise anatomic imaging modality, CT scanning, to localize the abscess. With prompt administration of intravenous antibiotics, the child recovered quickly and did not require surgery. The Ga-67 scan is thus a useful screening test to detect inflammatory foci because of its high sensitivity. It is also valuable in the follow-up of the patient's response to therapy.
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4/36. Transcervical foreign body.

    The uncommon occurrence of acute retropharyngeal abscess in adults can be the result of a retained foreign body. A large piece of wood impacted in the neck in a road traffic accident and presenting as retropharyngeal and bilateral parapharyngeal abscesses is reported for its rarity and clinical interest.
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5/36. The radiographic evaluation of infants with stridor.

    In the elective evaluation of infant stridor, inspiratory plain radiographs of the neck and chest are routinely obtained with fluoroscopy and a barium swallow when indicated. Several factors, including patient positioning, roentgenographic technique, and the phase of respiration, may significantly alter the appearance of the airway, reducing the diagnostic accuracy of this modality and leading to misinterpretation of the pathologic changes.
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6/36. Sequential parapharyngeal abscesses.

    Deep neck infections are not unusual in either the pediatric or adult populations. Multiple, and recurrent abscesses are found not infrequently, especially in immunocompromised and debilitated persons. It is very rare to find sequential parapharyngeal abscesses without identifiable etiology in an otherwise healthy pediatric patient while receiving appropriate, culture-directed, intravenous antibiotics. This could be due to underestimation of the extent of the infection by CT scanning. The use of intravenous clindamycin as a first-line therapy may not be sufficient if a large phlegmon exists. We describe a case of sequential, bilateral parapharyngeal abscesses in a 3-year-old patient.
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7/36. Atlantoaxial subluxation in an adult secondary to retropharyngeal abscess.

    Atlantoaxial subluxation secondary to a retropharyngeal abscess is well described in children, but very rare in adults. Only two adult cases have been reported in the literature. We present a case of severe atlantoaxial subluxation in an adult secondary to retropharyngeal abscess. His atlas-dens interval was very large, up to 10 mm in flexion. We tried external fixation with a neck collar initially, but for remaining instability, surgical fusion was performed. The mechanism of subluxation is attributed to softening of the ligament allowing greater mobility at the joint. The etiology of this process is speculative.
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8/36. Laryngeal squamous cell carcinoma presenting as a prelaryngeal neck abscess: report of two cases.

    head and neck tumours presenting as a neck abscess are extremely rare. Two patients with laryngeal squamous cell carcinoma, presenting with a prelaryngeal abscess, are described. Although clinically and on the CT studies these cases were suspect for underlying malignancy, the initial biopsies were negative for cancer. Because of persistent suspicion, repeat biopsies finally confirmed the presence of a squamous cell carcinoma. Pathological examination after total laryngectomy showed cancer localised in one of the true vocal cords, invading the anterior commissure and thyroid cartilage. However, the prelaryngeal soft tissues were free of tumour, showing only inflammatory changes and collections of pus. These cases emphasize the importance of repeat targeted biopsies and follow-up CT-studies in patients with a prelaryngeal abscess of obscure aetiology, in order to exclude or confirm a possible underlying malignancy.
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9/36. An unusual cause of stridor: retropharyngeal cold abscess.

    A 15-month-old female presented with a large swelling on the left lateral aspect of the neck and respiratory distress, and stridor due to incomplete obstruction of the upper airway. A lateral x-ray film and computerized tomography scan of the cervical spine showed a retropharyngeal abscess without vertebral involvement. Aspiration and contrast revealed it to be a bilobed tubercular abscess. Planned external drainage was done after 10 days under anti-tubercular drugs.
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10/36. Group B streptococcal retropharyngeal cellulitis in a young infant: a case report and review of the literature.

    The diagnosis of retropharyngeal cellulitis and abscess, although most common in children under 6 years of age, is often misdiagnosed in the newborn or early infancy period. The clinical signs of drooling, neck swelling, dysphagia, and torticollis may be absent or not easily identifiable. The following case report details a 2 1/2-month-old infant who presented with fever and irritability, and was subsequently diagnosed with group B streptococcal retropharyngeal cellulitis. Retropharyngeal cellulitis and abscess should be considered in the differential diagnosis of infants and young children who present with fever and irritability, particularly when lumbar puncture results are normal. This case also serves to highlight a rare manifestation of late-onset group B steptococcal disease.
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