Anterior and posterior parapharyngeal space infections

Main Article Content

Santiago Ucrós
Ana María Rodríguez

Abstract

Background


It has been difficult to standardize criteria for the diagnosis and treatment for infections of the parapharyngeal space; however, the use of computed axial tomography (CAT) technology has allowed redefining two separate entities: anterior and posterior parapharyngeal space infections.


Case summary


Girl of 3 years and 11 months of age with right ear pain, fever, drooling and neck spasm. The physical exam revealed right trapezius and sternocleidomastoid muscles spasm, and painful neck mobilization. The CAT showed right posterior parapharyngeal abscess. The patient was treated with crystalline penicillin, clindamycin and acetaminophen. The subsequent clinical evolution was excellent, and was discharged after ten days of treatment.


Conclusions


The two infections of the parapharyngeal space have different clinical features, treatment and prognosis. Anterior infections are prone to rapid expansion, leading to potentially fatal complications without fast and aggressive treatment, which includes surgical drainage. On the other hand, posterior space infections have a less aggressive course and usually require medical treatment only.


 

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How to Cite
Ucrós, S., & Rodríguez, A. M. (2017). Anterior and posterior parapharyngeal space infections. Pediatría, 46(1), 17–23. Retrieved from https://revistapediatria.org/rp/article/view/58
Section
Case report

References

1. Sichel JY, Attal P, Hocwald E, Eliashar R. Redefining parapharyngeal space infections. Ann Otol Rhinol Laryngol. 2006;115:117-23.

2. García AM. Absceso parafaríngeo: revisión bibliográfica y exposición de un caso clínico. Rev Otorrinolaringol. 2003;63:1.

3. Fédérici S, Silva C, Maréchal C, Laporte E, Sévely A, Grouteau E, et al. Infections retro et parapharyngées: vers une harmonisation despratiques. Arch Pediatr. 2009;16:1225-32.

4. Al-Sabah B, Bin Salleen H, Hagr A, Choi-Rosen J, Manoukian JJ, Tewfik TL. Retropharyngeal abscess in children: 10-year study. J Otolaryngol. 2004;33:352.

5. Yasan H, Dogru H, Ozel BF, Baykal B. Difficulty in the diagnosis and management of parapharyngeal abscess: Foreign body? KBB Forum. 2005;4:192-4.

6. Brito-Mutunayagam S, Chew YK, Sivakumar K, Prepageran S. Parapharyngeal and retropharyngeal abscess: Anatomical complexity and etiology. Med J Malaysia. 2007;62:413-5.

7. Parhiscar A, Har-El G. Deep-neck abscess: A retrospective review of 210 cases. Ann Otol Rhinol Laryngol. 2001;110:1051-4.

8. Mejrek RC, Coticchia JM, Arnold JE. Presentation, diagnosis, and management of deep-neck abscess in infants. Arch Otolaryngol Head Neck Surg. 2002;128:1361-4.

9. McClay JE, Murray AD, Booth T. Intravenous antibiotic therapy for deep-neck abscess defined by computed tomography. Arch Otolaryngol Head Neck Surg. 2003;129:1207-12.

10. Tagliareni JM, Clarkson EI. Tonsillitis, peritonsillar and lateral pharyngeal abscesses. Oral Maxillofac Surg Clin North Am. 2012;24:197-204.