Pediatria pre prax 6/2018
Parapharyngeal abscess in children
Abscesses in the pharyngeal region (retropharyngeal and parapharyngeal) are rare in children, but may put the patient at risk for serious complications. In order to prevent these complications, early recognition, diagnosis and treatment are essential, however may be challenging to pediatricians. In terms of differential diagnosis, symptoms may point to a alternative diagnoses, especially – when torticollis is the leading symptom. However, in the presence of other accompanying systemic symptoms, a possible inflammatory process in the area of the pharynx should be considered. Initial treatment with systemic antibiotics is a generally accepted therapeutic approach. As to surgical treatment, the indications, timing and technique of surgery are subject to debate among otorhinolaryngologists. We present the case of a 15-year-old patient who was initially admitted to the Clinic of Paediatric Neurology of the Medical Faculty of the Comenius University in Bratislava and the National Institute of Children’s Diseases with tortitcollis and the working diagnosis of cervicocranial syndrome. Due to throat pain, swallowing difficulties and rising inflammatory parameters a parapharyngeal abscess was suspected and she was transferred to the Children‘s ENT Clinic for further diagnosis and treatment. Herein, we review the history, clinical course of the disease and the diagnostic and therapeutic management of the patient.
Keywords: parapharyngeal abscess, retropharyngeal abscess, torticollis, cervical abscess in children
