Rivista di formazione e aggiornamento professionale del pediatra e del medico di base, fondata nel 1982. In collaborazione con l'Associazione Culturale Pediatri.
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Problemi speciali

L’ascesso retrofaringeo

Retropharyngeal abscess

Anna Favret1, Claudio Germani1, Giorgio Pelos2, Elisa Benelli2, Massimo Gregori3, Egidio Barbi1

1SCO Pediatria d’urgenza e Pronto Soccorso; 2SCO ORL; 3SCO Radiologia, IRCCS Materno-Infantile “Burlo Garofolo”, Trieste

Marzo 2013 - pagg. 159 -166

Abstract
Retropharyngeal abscess in children is a rare suppurative complication of upper respiratory infections. Clinical manifestations can be variable but the most common features are fever, neck pain, neck lymphoadenopathy, neck mass, torticollis, neck stiffness, drooling, dysphagia, and sore throat. Less frequently, it might present with respiratory findings. Physical examination can show pharyngeal wall bulging which is pathognomonic but not always present. Retropharyngeal abscess can cause serious complications that might eventually lead to death. The potential seriousness of the pathology has decreased because of advances in imaging allowing an early detection. Indeed, over the years, there has been a remarkable reduction of the incidence of complications and mortality. However, several studies highlight a significant increase in incidence in the last ten years. CT seems to be the gold diagnostic standard because of its high sensitivity. This article provides a review of the recent literature about etiopathogenesis, epidemiology, clinical features, diagnosis and therapy. Finally, the experience of the authors’ Institution in the last 10 years is reported.
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Bibliografia
1. Philipott CM, Selvadurai D, Banerjee AR. Paediatric retropharyngeal abscess J Laryngol Otol 2004;118:919-26. 2. Kliegman RM, Stanton BF, St Geme JW, Schor NF, Behrman RE. Nelson Textbook of Pediatrics. 19th edition, Elsevier 2011. 3. Grisaru-Soen G, Komisar O, Aizenstein O, Soudack M, Schwartz D, Paret G. Retropha-ryngeal and parapharyngeal abscess in children - Epidemiology, clinical features and treatment. Int J Pediatr Otorhinolaryngol 2010;74:1016-20. 4. Elsherif AM, Park AH, Alder SC, Smith ME, Muntz HR, Grimmer F. Indicators of a more complicated clinical course for pediatric patients with retropharyngeal abscess. Int J Pediatr Otorhinolaryngol 2010;74:198-201. 5. Page C, Bauer EM, Lieu JE. Clinical features and treatment of retropharyngeal abscess in children Otolayngol. Head Neck Surg 2008; 138:300-6. 6. Kelly CP, Isaacman DJ. Group B streptococcal retropharyngeal cellulitis in a young infant: a case report and review of the literature. J Emerg Med 2002;23:179-82. 7. Abdel-Haq NM, Harahsheh A, Asmar BL. Retropharyngeal abscess in children: the emerging role of group A beta hemolytic Streptococcus. South Med J 2006;99:927-31. 8. Hofmann C, Pierrot S, Contencin P, Morriseau-Durand MP, Manach Y, Couloigner V. Retropharyngeal infections in children. Treatment strategies and outcomes. Int J Pediatr Otorhinolaryngol 2011;75:1099-103. 9. Wright CT, Stocks RM, Armstrong DL, Arnold SR, Gould HJ. Pediatric mediastinitis as a complication of methicillin-resistant Staphylococcus aureus retropharyngeal abscess. Arch Otolaryngol Head Neck Surg 2008;134: 408-13. 10. Baldassari CM, Howell R, Amorn M, Budacki R, Choi S, Pena M. Complications in pediatric deep neck space abscesses. Otolaryngol Head Surg 2011;144:592-5. 11. Chang L, Chi H, Chiu NC, Huang FY, Lee KS. Deep neck infections in different age groups of children. J Microbiol Immunol Infect 2010;43:47-52. 12. Coulthard M, Isaacs D. Retropharyngeal abscess. Arch Dis Child 1991;66:1227-30. 13. Thompson JW, Cohen SR, Reddix P. Retropharyngeal abscess in children: a retrospective and historical analysis. Laryngoscope 1988;98:589-92. 14. Craig FW, Schunk JE. Retropharyngeal abscess in children: clinical presentation, utility of imaging, and current management. Pediatrics 2003;111:1394-8. 15. Kirse DJ, Roberson DW. Surgical management of retropharyngeal space infection in children. Laryngoscope 2001;111:1413-22. 16. Daya H, Lo S, Papsin BC, et al. Retropha-ryngeal and parapharyngeal infections in children: the Toronto experience. Int J Pediatr Otorhinolaryngol 2005;69:81-6. 17. Maroldi R, Farina D, Ravanelli M, Lombardi D, Nicolai P. Emergency imaging assessment of deep neck space infections. Semin Ultrasound CT MR 2012;33:432-42. 18. AAVV. Linee guida italiane “Gestione della faringotonsillite in etŕ pediatrica”; http:// www.snlg-iss.it/cms/files/LG_faringotonsillite.pdf. 19. Afolabi OA, Fadare JO, Oyewole EO, Ogah SA. Fish bone foreign body presenting with an acute fulminating retropharyngeal abscess in a resource-challenged center: a case report. J Med Case Rep 2011;5:165. 20. Cheng W, Tam PK. Foreign-body ingestion in children: experience with 1,265 cases. J Pediatr Surg 1999;34:1472-6. 21. Marra S, Hotaling AJ. Deep neck infections. Am J Otolaryngol 1996;17:287-98. 22. Harma A, Firat Y. Grisel syndrome: nontraumatic atlantoaxial rotatory subluxation. J Craniofacial Surg 2008;19:1119-21. 23. Yu KK, White DR, Weissler MC, Pillsbury HC. Nontraumatic atlantoaxial subluxation (Grisel syndrome): a rare complication of otolaryngological procedures. Laringoscope 2003; 113:1047-49.

Corrispondenza: annafavret@gmail.com