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Clin Otolaryngol 2019 Feb 19. Epub 2019 Feb 19.

Department of Otorhinolaryngology - Head and Neck Surgery, Alder Hey Children's Hospital, Eaton Road, Liverpool, L12 2AP.

Objectives: Surgical drainage is the traditional mainstay of treatment of paediatric deep neck space infection (DNSI), but recently non-operative management in selected cases has been advocated. We sought to identify any characteristics predictive of requirement for surgical intervention.

Design: Retrospective cohort study using receiver-operating characteristics analyses. Read More

BMJ Case Rep 2019 Feb 6;12(2). Epub 2019 Feb 6.

Department of General Surgery, University Hospital Crosshouse, Kilmarnock, Scotland.

Tonsillitis is an extremely common condition, usually it is self-limiting, of viral origin, and managed conservatively in general practice. Rarely patients require inpatient management, usually when bacterial infection is present or when the cause is virulent organisms such as Epstein Barr virus. Complications can be divided into non-suppurative; sepsis, scarlet fever, rheumatic fever, glomerulonephritis and Lemierres disease, and suppurative; quinsy, parapharyngeal abscess and retropharyngeal abscess, respectively. Read More

Glob Pediatr Health 2019 23;6:2333794X18822999. Epub 2019 Jan 23.

Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.

Fever of unknown origin is an important diagnostic challenge in pediatrics that requires a thoughtful approach. The differential diagnosis is broad and includes infectious, autoimmune, oncologic, neurologic, genetic, and iatrogenic causes. Infection remains the most common etiology, and uncommon presentations of infections are still more likely than classic presentations of rare conditions. Read More

Acta Neurochir Suppl 2019 ;125:147-149

Department of Neurosurgery, St Michael's Hospital, University of Toronto, Toronto, ON, Canada.

The first high cervical anterolateral retropharyngeal (HCALR) approach was reported by Stevenson et al. for a clivus chordoma in 1966. Anterior approaches to the spine have often been developed in response to problems presented by tuberculous spondylitis. Read More

BMJ Case Rep 2018 Nov 28;11(1). Epub 2018 Nov 28.

Fiona Stanley Hospital, Murdoch, Western Australia, Australia.

Emerg Infect Dis 2019 Jan;25(1):187-189

We report a case of severe disseminated infection in an immunocompetent man caused by an emerging lineage of methicillin-sensitive Staphylococcus aureus clonal complex 398. Genes encoding classic virulence factors were absent. The patient made a slow recovery after multiple surgical interventions and a protracted course of intravenous flucloxacillin. Read More

J Clin Microbiol 2018 Dec 27;56(12). Epub 2018 Nov 27.

Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA

J Clin Microbiol 2018 Dec 27;56(12). Epub 2018 Nov 27.

Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA

Emerg Med Clin North Am 2019 Feb;37(1):95-107

Department of Emergency Medicine, Loma Linda University School of Medicine, 11234 Anderson Street MC A-108, Loma Linda, CA 92354, USA. Electronic address:

Infection of the neck is a relatively common emergency department complaint. If not diagnosed and managed promptly, it may quickly progress to a life-threatening infection. These infections can result in true airway emergencies that may require fiberoptic or surgical airways. Read More

Emerg Med Clin North Am 2019 Feb;37(1):69-80

Department of Emergency Medicine, Northwestern University, 211 East Ontario - Suite 300, Chicago, IL 60611, USA. Electronic address:

This article reviews the presentation, diagnosis, and management of common and "can't miss" infections of the oropharynx, including streptococcal pharyngitis, infectious mononucleosis, peritonsillar abscess, retropharyngeal abscess, and epiglottitis. Read More

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018 Nov;53(11):854-855

Department of Otorhinolaryngology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 311100, China.

Paediatr Int Child Health 2018 Oct 4:1-3. Epub 2018 Oct 4.

c Department of ENT , Nanavati Hospital , Mumbai , India.

Paradoxical reactions (PRs) are exaggerated inflammatory responses owing to recovery of cellular immunity following initiation of anti-tuberculous therapy (ATT). The presentation is worsening of pre-existing symptoms or development of new lesions. A 14-year-old girl with multi-drug-resistant tuberculosis developed a recurrent asymptomatic retropharyngeal abscess while on ATT. Read More

Presse Med 2018 Oct 30;47(10):918-921. Epub 2018 Sep 30.

University Tunis el Manar, Habib Thameur Hospital, Faculty of Medicine of Tunis, Internal Medicine Department, Ali-Ben-Ayed Street, Montfleury, 1008 Tunis, Tunisia.

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018 Sep;32(17):1304-1308

Department of Otorhinolaryngology Head and Neck Surgery, Ningde Municipal Hospital affiliated of Fujian Medical University, Ningde Institute of Otolaryngology, Ningde, 352100, China.

To identify the clinical risk factors related to the increased likelihood of surgical drainage and medical therapy failure in parapharyngeal and retropharyngeal abscess. The charts of 93 consecutive patients from January 2006 to April 2017 with parapharyngeal and retropharyngeal abscess were reviewed retrospectively. Logistic regression analysis was used to study the clinical risk factors. Read More

Case Rep Infect Dis 2018 4;2018:6051641. Epub 2018 Sep 4.

Department of Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka.

Acinetobacter species frequently causes nosocomial infection, particularly in patients receiving invasive ventilation at intensive care units for a prolonged period. Odynophagia is a rare, initial clinical manifestation of prevertebral abscess which subsequently develops when the abscess extends into the retropharyngeal space causing a midline bulge of the posterior pharyngeal wall. Here, we present and discuss a patient with uncontrolled diabetic mellitus who presented with severe odynophagia and dysphagia. Read More

Pediatr Emerg Care 2018 Sep;34(9):e161-e164

Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation.

Neck abscesses such as retropharyngeal, peritonsilar, and lateral pharyngeal are well described, typically cause a characteristic illness, and have a known epidemiology. We present a rare occurrence of case of confluent, mixed retropharyngeal, lateral pharyngeal, and peritonsilar abscess in a 9-month-old female infant. The symptoms at presentation were very mild and not expected in association with this extensive an abscess. Read More

Int J Pediatr Otorhinolaryngol 2018 Oct 26;113:134-139. Epub 2018 Jul 26.

Caruso Department of Otolaryngology, Head and Neck Surgery Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Division of Otolaryngology, Head and Neck Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address:

Objective: To assess geographical sociodemographic differences in neck abscesses that require surgical drainage in Los Angeles.

Study Design: retrospective review.

Methods: We reviewed the medical records of 119 consecutive pediatric patients at Children's Hospital Los Angeles (CHLA) from 2014 to 2017 with a diagnosis of a neck abscess requiring incision and drainage. Read More

Pediatr Emerg Care 2018 Aug;34(8):e139-e140

Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Minnesota, Minneapolis, MN.

Stridor is a common presenting symptom in young children and is produced by turbulent flow through the upper airway or trachea. In children under 12 months of age, stridor is commonly caused by laryngomalacia, tracheomalacia, croup, airway foreign body, and/or retropharyngeal abscess. In atypical presentations of stridor, soft tissue neck radiographs can be helpful to determine the underlying etiology. Read More

Gastroenterol Nurs 2018 Jul/Aug;41(4):347-351

Michael Doulberis, PhD, MD, DVM, Department of Internal Medicine, Bürgerspital Hospital of Solothurn, Solothurn, Switzerland; and Division of Gastroenterology, Second Department of Internal Medicine, Ippokration Hospital, Medical School of Aristotle University, Thessaloniki, Macedonia, Greece. Jörg Dähn, MD, Department of Otorhinolaryngology, Bürgerspital Hospital of Solothurn, Solothurn, Switzerland. Jannis Kountouras, PhD, MD, is Professor, Division of Gastroenterology, Second Department of Internal Medicine, Ippokration Hospital, Medical School of Aristotle University, Thessaloniki, Macedonia, Greece. Volker Maier, MD, Department of Internal Medicine, Bürgerspital Hospital of Solothurn, Solothurn, Switzerland. Arthur Helbling, MD, is Professor, Division of Allergology, University Clinic of Rheumatology, Immunology & Allergology, Inselspital/University Hospital Bern, Switzerland. Patrick Dubach, MD, is Head, Department of Otorhinolaryngology, Bürgerspital Hospital of Solothurn, Solothurn, Switzerland.

BMJ Case Rep 2018 Jun 21;2018. Epub 2018 Jun 21.

Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.

This case series is about four different foreign bodies lodged in different locations of the aerodigestive tract. All four cases had delayed diagnosis due to inconspicuous history. Radiology in the form of computed tomography aided the appropriate diagnosis in most of these cases. Read More

BMJ Case Rep 2018 May 30;2018. Epub 2018 May 30.

Radiology, Fiona Stanley Hospital, Murdoch, Australia.

Descending necrotising mediastinitis (DNM) is an uncommon clinical entity which may arise secondary to primary odontogenic or neck infection in susceptible patients. Infection may spread contiguously via the alar or 'danger' space, a potential anatomical space posterior to the true retropharyngeal space. Spread of infection to the mediastinum almost always necessitates urgent cardiothoracic surgical intervention. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017 Jul;31(13):1031-1033

Trop Doct 2018 Jul 14;48(3):179-182. Epub 2018 May 14.

4 Professor, Department of Otorhinolaryngology, Christian Medical College, Vellore.

In order to study the bacteriological profile, antibiotic sensitivity and outcome following empirical therapy with early generation antibiotics in patients with deep head and neck infection, a retrospective review of 42 patients admitted for drainage and intravenous antibiotic therapy was performed. Ludwig's angina was the commonest infection, with the most common organisms isolated being Group F ß-haemolytic (15%) and non-haemolytic (12.5%) streptococcus. Read More

Int J Pediatr Otorhinolaryngol 2018 Jun 24;109:40-43. Epub 2018 Mar 24.

Department of ENT, MAMC, New Delhi, India.

Objectives: To study the outcomes and complications of deep neck space abscesses in children less than 5 years of age over a period of 15 years.

Methods: A retrospective analysis of children less than 5 years of age with deep neck space abscesses over a 15-year period was conducted at a tertiary care centre in India. Patients were evaluated with respect to the clinical, radiological and laboratory findings. Read More

Int J Pediatr Otorhinolaryngol 2018 Jun 7;109:149-153. Epub 2018 Apr 7.

Department of Pediatrics, Division of Inpatient Medicine, 50 N Medical Drive, University of Utah, Salt Lake City, UT 84132, USA; Primary Children's Hospital, Salt Lake City, UT 84113, USA.

Objective: Review the evaluation of children with a deep lateral neck infection and define the impact of initial imaging modality on outcomes and costs.

Method: Case series, pediatric patients <18 years of age admitted to a tertiary care hospital with lateral neck infection between 01/01/14-05/31/16 as identified by ICD-9 and ICD-10 codes: 289.3 (lymphadenitis, unspecified), 682. Read More

Intern Med 2018 Sep 27;57(18):2759-2761. Epub 2018 Apr 27.

Department of Neurology, Toranomon Hospital and Okinaka Memorial Institute for Medical Research, Japan.

The diagnosis of longus colli tendinitis (LCT) is sometimes challenging, especially when laboratory data show marked inflammation and neuroimaging studies do not indicate calcification within the tendon of the longus colli muscles. We herein report a case of LCT that presented with elevated inflammation parameters without calcification on imaging. Findings characteristic of LCT, such as prevertebral hyperintensity areas on T2-weighted images and no signs of purulent diseases, informed our diagnosis of LCT. Read More

J Neurosurg Spine 2018 Jul 20;29(1):10-17. Epub 2018 Apr 20.

OBJECTIVE Intraoperative local steroid application has been theorized to reduce swelling and improve swallowing in the immediate period following anterior cervical discectomy and fusion (ACDF). Therefore, the purpose of this study was to quantify the impact of intraoperative local steroid application on patient-reported swallow function and swelling after ACDF. METHODS A prospective, randomized single-blind controlled trial was conducted. Read More

Medicine (Baltimore) 2018 Apr;97(16):e0488

Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea.

Rationale: There have been many reports of non-thyroidal lesions which can be mistaken for thyroidal lesions on ultrasound (US) examination. However, it is not known that pyriform sinus fistula (PSF) can manifest as an incidental thyroid nodule and cause serious complication on fine-needle aspiration (FNA).

Patient Concerns: We present a 34-year-old man with PSF incidentally detected on US. Read More

Ann Am Thorac Soc 2018 Jun;15(6):643-654

1 Pulmonary and Critical Care Section, Department of Medicine, Veterans Affairs San Diego Healthcare System, San Diego, California; and.

Diseases affecting the ear, nose, and throat are prevalent in intensive care settings and often require combined medical and surgical management. Upper airway occlusion can occur as a result of malignant tumor growth, allergic reactions, and bleeding events and may require close monitoring and interventions by intensivists, sometimes necessitating surgical management. With the increased prevalence of immunocompromised patients, aggressive infections of the head and neck likewise require prompt recognition and treatment. Read More

J Emerg Med 2018 05 6;54(5):619-629. Epub 2018 Mar 6.

Department of Emergency Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas.

Background: Pharyngitis is a common disease in the emergency department (ED). Despite a relatively low incidence of complications, there are many dangerous conditions that can mimic this disease and are essential for the emergency physician to consider.

Objective: This article provides a review of the evaluation and management of group A β-hemolytic Streptococcal (GABHS) pharyngitis, as well as important medical conditions that can mimic this disease. Read More

Am J Otolaryngol 2018 May - Jun;39(3):372. Epub 2018 Mar 5.

Department of Otolaryngology, Vanderbilt University School of Medicine, United States.

PLoS One 2018 6;13(3):e0193913. Epub 2018 Mar 6.

Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea.

Objectives: The purpose of this study is to evaluate the risk of retropharyngeal and parapharyngeal abscesses (deep neck infection) after tonsillectomy in Koreans using national cohort data.

Methods: Using the national cohort study from the Korean Health Insurance Review and Assessment Service, participants who had undergone a tonsillectomy (5,299) and control participants (21,196) were selected and matched 1:4 (for age, sex, income, region of residence, and pre-operative upper respiratory infection visits). The Cox-proportional hazard model was used. Read More

BMJ Case Rep 2018 Mar 5;2018. Epub 2018 Mar 5.

ENT, NHS Greater Glasgow and Clyde, Glasgow, UK.

Chemotherapy increases susceptibility to infection due to the effect on cell-mediated and humoral immunity. Retropharyngeal abscess is a serious head and neck infection that rapidly progresses from toxicity, whether the patient is neutropenic or not. The risk should be carefully assessed with any chemotherapeutic agent, especially docetaxel. Read More

Paediatr Int Child Health 2018 Mar 1:1-3. Epub 2018 Mar 1.

c Department of Pediatric Surgery , SAT, Government Medical College , Trivandrum , India.

Tuberculous adenitis presenting as an isolated cold abscess in the parapharyngeal space is very uncommon and has not been reported in the paediatric age group; presentation as a retropharyngeal abscess, however, is well known. Nine-year-old boy with a progressively increasing swelling on the right side of the neck for 2 months was referred with a clinical diagnosis of neuroblastoma. Surgical exploration of the parapharyngeal space by needle aspiration yielded a cheesy material and Mycobacterium tuberculosis was detected by DNA TB PCR. Read More

BMJ Case Rep 2018 Jan 11;2018. Epub 2018 Jan 11.

Department of Intensive Care Unit, Gelderse Vallei Hospital, Ede, The Netherlands.

Turk J Med Sci 2017 Dec 19;47(6):1842-1847. Epub 2017 Dec 19.

Background/aim: Our aim was to interpret the effects of deep neck space abscesses on the adjacent carotid artery according to abscess location, as well as to determine narrowing by calculating the mean stenosis ratios.Materials and methods: Neck computed tomography scans and clinical data of 45 children with neck abscesses were evaluated retrospectively for abscess location and internal carotid artery narrowing. The lumen areas of the carotid arteries were measured from standard levels, and stenosis ratios were calculated with two different techniques. Read More

Clin Nucl Med 2018 Mar;43(3):209-212

A 50-year-old woman complained postprandial vomiting for 5 days and drowsiness for 3 days. Possible central nervous pathology was suspected clinically. Brain MRI suggested likely brain metastases. Read More

Spine J 2018 03 15;18(3):540-546. Epub 2017 Dec 15.

Helios Klinikum Erfurt, Nordhaeuser St 74, 99089 Erfurt, Germany.

Background Context: Surgical approaches to the craniovertebral junction (CVJ) are challenging. Available approaches include posterior, transoral, endonasal, and anterior extended retropharyngeal approach. Resection of the odontoid process is necessary to gain access to the pathology posterior to it. Read More

Int Med Case Rep J 2017 23;10:381-384. Epub 2017 Nov 23.

Department of Pediatric Otolaryngology-Head & Neck Surgery, Nationwide Children's Hospital.

Retropharyngeal abscesses in the pediatric population can cause severe respiratory distress. We report a rare case of significant airway obstruction in a 14-month-old patient requiring rapid, emergent tracheotomy after attempts at endotracheal intubation by an experienced airway surgeon were unsuccessful. The patient was diagnosed with streptococcal pharyngitis 9 days prior to presentation to our facility and was being treated with amoxicillin. Read More

IDCases 2017 8;10:130-131. Epub 2017 Nov 8.

Department of Otolaryngology, Aichi Medical University, Japan.

Otolaryngol Pol 2017 Oct;71(5):37-42

Pauls Stradins Clinical University Hospital, Rīga, Latvia.

Objectives: In patients hospitalized due to deep neck infections (DNIs), to investigate the association between demographic parameters, etiology, and localization of abscesses and/or phlegmons, complications, comorbidities, treatment, and bacterial cultures.

Methods: We analyzed data of 263 patients that were hospitalized from January 1, 2012, to December 31, 2015, due to deep neck space phlegmons and/or abscesses. We performed statistical analysis with the SPSS 22. Read More

BMJ Open 2017 Nov 15;7(11):e016221. Epub 2017 Nov 15.

Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.

Objectives: To investigate if use of antibiotics was associated with bacterial complications following upper respiratory tract infections (URTIs).

Design: Ecological time-trend analysis and a prospective cohort study.

Setting: Primary, outpatient specialist and inpatient care in Stockholm County, Sweden. Read More

Medicine (Baltimore) 2017 Nov;96(46):e8343

Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences, Gwangju, Korea.

Study Design: Case description.

Objective: Acute calcific tendinitis of the longus colli muscle is a rare clinical entity that causes severe neck pain. This entity is not well recognized due to its nonspecific presentation such as acute neck pain, neck stiffness, and odynophagia. Read More

Int J Surg Case Rep 2017 11;41:343-346. Epub 2017 Nov 11.

Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS, B3K 6R8, Canada.

Introduction: Acute calcific longus colli tendinitis, also known as retropharyngeal or acute calcific prevertebral tendinitis, is a reactive self-limiting inflammatory response to acute or subacute deposition of amorphous calcium hydroxyapatite crystals in the tendons of the longus colli muscle, anterior to the C1-C2 disk space.

Case Presentation: A 53-year-old man presented with a complaint of neck pain and odynophagia over a few days. Blood test findings showed mild leukocytosis and elevated C-reactive protein level. Read More

J Emerg Med 2017 10;53(4):568-569

Division of Emergency Medicine, University of Toronto, Ontario, Canada; Department of Emergency Medicine, University Health Network, Toronto, Ontario, Canada.

Vestn Otorinolaringol 2017;82(5):12-14

Morozovskaya City Children's Clinical Hospital, Moscow Health Department, Moscow, Russia, 119049.

The present study was undertaken for the purpose of elucidating the specific features of the past medical history and the etiological factors responsible for the development of tonsillogenic pharyngeal abscesses in the children. We performed the retrospective analysis of the medical histories of 291 children presenting with this condition who had been admitted for the treatment to the ENT Department of the Morozovskzya City Children's Clinical Hospital during the period from January till December 2015. The study has demonstrated the following most common shortcomings of the outpatient treatment of the patients suffering from chronic tonsillitis at the stage preceding formation of paratonsillar abscess: inadequate antibacterial therapy of acute chronic tonsillitis or its exacerbation and limited indications for tonsillectomy at the level of the outpatient treatment. Read More

Cureus 2017 Aug 23;9(8):e1597. Epub 2017 Aug 23.

Department of Radiology, Yale New Haven Health System.

Acute calcific tendinitis (ACT) of the longus colli muscle is a rare cause of debilitating neck pain. The ACT is presumed to be an aseptic inflammatory process of the superior oblique tendons of the longus colli muscle. It is often confused with other more concerning conditions including trauma, epidural abscess, disc herniation, and neoplasm. Read More

Ann R Coll Surg Engl 2018 02 19;100(2):129-134. Epub 2017 Oct 19.

NHS Greater Glasgow and Clyde , UK.

Introduction The incidence of deep neck space infection (DNSI) is rising and appears to be related to falling rates of tonsillectomy. The purpose of this study was to assess demographics of patients presenting with DNSI and the financial burden to the National Health Service (NHS). Methods Data were collected retrospectively on patients aged over 16 years admitted to NHS Greater Glasgow and Clyde with DNSI between 2012 and 2016. Read More

BMJ Case Rep 2017 Oct 9;2017. Epub 2017 Oct 9.

Department of Otorhinolaryngology, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia.

Severe extensive deep neck abscess in an infant is uncommon. We share the case of a previously well 4-month old infant who was referred for a 4-day history of fever, lethargy and left lateral neck swelling. Contrast-enhanced CT scan revealed a large 5. Read More

Rev Med Suisse 2017 Oct;13(577):1698-1702

Service d'ORL et de chirurgie cervico-faciale, CHUV, 1011 Lausanne.

A retropharyngeal abscess is a collection of pus located behind the posterior pharyngeal wall. Main symptoms include torticoli, pyrexia and odynodysphagia. It can be secondary to upper airway infections, pharyngeal penetrating trauma or idiopathic. Read More