Article in Japanese

Clinical characteristics of retropharyngeal abscess in children

Junya TSUKAMOTO¹⁾, Kazuhiro UDA^2,3), Mizuki YANO¹⁾, Kotaro ARAKI^2,3), Kahoru FUKUOKA^2,3), Takahiro MATSUSHIMA¹⁾, Satoko SUZUKI¹⁾, Hiroshi SAKAKIBARA¹⁾, Hiroshi HATAYA¹⁾, Yuho HORIKOSHI^2,3)

Retropharyngeal abscesses typically occur among children younger than 5 years. The clinical presentation includes dysphagia, neck stiffness, and trismus; however, details about the duration of fever, incidence of clinical symptoms, and treatment have not yet been reported in Japanese children. This study reviewed cases of retropharyngeal abscess retrospectively between March 2010 and March 2019 at Tokyo Metropolitan Children's Medical Center and recorded the demographic data, symptoms, clinical course of the patients, and treatment. There were 27 and 6 cases of retropharyngeal abscess and cellulitis, respectively. The median age and percentage of male patients and that of children aged 5 years or older was 40 months, 76%, and 36%, respectively. Fever was observed in 97% of the cases, and the patients were diagnosed within three days in 45%. Common findings on examination included at least one of following in 97% of the cases: cervical swelling (79%), restricted neck movement (42%), snoring (30%) and drooling (15%). Initial treatment of ampicillin/sulbactam was administered and surgical drainage performed in 88% and 49% of the cases, respectively.
In conclusion, cases with a short duration of fever (< 3 days) and/or older age (≥ 5 years) were common. Despite the challenges of diagnosing retropharyngeal abscess early, cervical swelling, restricted neck movement, snoring, and drooling might be helpful clues.

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1) Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center
2) Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center
3) Division of Immunology, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center

Key words	retropharyngeal abscess, deep neck abscess, children
Received	September 26, 2019
Accepted	January 6, 2020

32 (1)：19─26,2020