title: A pain in the neck: non-traumatic adult retropharyngeal abscess.
abstract: BACKGROUND
  We present the case of a 47-year-old man who presented to the Emergency Department (ED) with complaint of left-sided neck pain. He was thought to have a musculoskeletal sprain on his initial visit. However, he returned the following evening with worsening symptoms. On further investigation, he was found to have a non-traumatic retropharyngeal abscess (RPA), a rare infection in the adult patient population.
  
  
  OBJECTIVE
  This infection has been studied primarily in the pediatric population, and extrapolation of their studies demonstrates the importance of airway stabilization, antibiotic use targeting polymicrobial organisms, and conservative medical management vs. surgical drainage. We aim to summarize this case and review the literature on retropharyngeal abscess.
  
  
  METHODS
  This patient presented to the ED with complaints of left-sided neck pain. There was no history of trauma or injury to the affected area. He was evaluated and discharged but returned with a deteriorating clinical picture. On further evaluation, he was found to have a non-traumatic RPA. He was admitted to the Otolaryngology service and managed conservatively with intravenous (IV) antibiotics. His condition resolved and he was subsequently discharged from the hospital.
  
  
  CONCLUSIONS
  The majority of data on diagnosis and treatment of adult RPA have come from the pediatric population. However, the same essential treatment principles apply: airway stabilization, resuscitation, initiation of IV antibiotics, and consultation with an otolaryngology specialist.
authors.affiliation: Department of Emergency Medicine, Eastern Virginia Medical School, Norfolk, VA 23507, USA.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Schott
authors.forename: Francis L
authors.initials: FL
authors.lastname: Counselman
authors.forename: Allison R
authors.initials: AR
authors.lastname: Ashe
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D003907:Dexamethasone / Q000031:analogs & derivatives / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007964:Leukocytosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D019547:Neck Pain / Q000209:etiology*; D017703:Retropharyngeal Abscess / Q000175:diagnosis* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; C004180:dexamethasone 21-phosphate; D002981:Clindamycin; D003907:Dexamethasone