Delayed Recognition and Drainage of a Pediatric Retropharyngeal Abscess with Parapharyngeal Extension in a Resource-Limited Setting: A Case Report.
Mohamed Abdirahman Mohamud, Tabu Geoffrey
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Case in brief
A 4-year-old boy presented with 4 days of right lateral neck swelling, fever, muffled voice, and breathing difficulty. Initial ultrasonography suggested Ludwig's angina, but the clinical findings were inconsistent. After deterioration, he underwent emergency tracheostomy and drainage, revealing a retropharyngeal abscess. Following definitive drainage and supportive care, he improved and was discharged on hospital day 20.
Diagnostic / clinical pearl
In cases of progressive neck swelling with airway symptoms, a negative aspiration or discordant imaging should prompt urgent cross-sectional imaging or surgical reassessment to prevent airway compromise.
Why it matters
This case underscores the importance of timely diagnosis and intervention in deep neck infections, particularly in resource-limited settings, to avoid serious complications.