Anterior and posterior parapharyngeal space infections
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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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