Clinical features and treatment of retropharyngeal abscess in children.
OBJECTIVE
To characterize presentation, treatment, and outcomes of pediatric retropharyngeal abscess (RPA) and determine optimal treatment.


METHODS
Retrospective cohort.


METHODS
Chart review of 162 pediatric patients with RPA.


RESULTS
Initial treatment was surgery in 126 and intravenous antibiotics in 36, of which 17 required surgery. Findings were negative in 30, murky fluid in 34, and pus in 79. Factors predicting positive surgical drainage were duration of symptoms for more than 2 days, prior antibiotic treatment, and CT lesion cross-sectional area >2.0 cm(2). A history of rash was a negative predictor. The mean length of stay (LOS) was 4.8 vs 3.6 days (P = 0.14), and duration of fever (DOF) was 2.5 vs 1.4 days (P = 0.01) for patients with no fluid and fluid at surgery, respectively. For antibiotic vs surgery groups, LOS was 4.4 vs 3.6 days (P = 0.14) and DOF was 2.4 versus 1.5 days (P = 0.0061).


CONCLUSIONS
These predictive factors may be useful in selecting patients with retropharyngeal abscesses who might be treated with intravenous antibiotics alone.
Page
Nathan C
NC
Department of Otolaryngology, Washington University School of Medicine, St Louis, MO 63110, USA.
Bauer
Erik M
EM
Lieu
Judith E C
JE
D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D004322:Drainage; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D017703:Retropharyngeal Abscess / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D012189:Retrospective Studies