title: Neck swelling from a retropharyngeal abscess caused by penicillin-resistant Streptococcus pneumoniae: a case report.
abstract: BACKGROUND
  In small children, retropharyngeal abscesses usually occur after upper respiratory tract infections. Unlike in adults, these abscesses are difficult to diagnose in small children, and can rapidly develop into deep neck or mediastinal abscesses.
  
  
  METHODS
  A 2-year-old Japanese boy recently presented to our department with a chief complaint of neck swelling. Physical examination revealed bilateral tonsillitis and swelling of the left posterior pharyngeal wall. Emergency neck computed tomography angiography showed a contrast-enhanced abscess cavity posterior to the left retropharyngeal space, and a low-density area surrounded by an area without contrast enhancement in the posterior neck. The latter was suspected to be a deep neck infection secondary to a retropharyngeal abscess. After surgery, the patient was diagnosed with a retropharyngeal abscess and concurrent cystic lymphangioma. The lesions improved after intraoral incision and drainage, and administration of antibiotics.
  
  
  CONCLUSIONS
  Lymphangiomas and retropharyngeal abscesses are both known to be more common in children than in adults. However, we found no other reports of concomitant presentation of lymphangioma and retropharyngeal abscess in the literature.
authors.affiliation: Department of Otolaryngology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan. yuki-hyo@med.kawasaki-m.ac.jp.
authors.forename: Yukiyoshi
authors.initials: Y
authors.lastname: Hyo
authors.forename: Hisaki
authors.initials: H
authors.lastname: Fukushima
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Harada
mesh_terms: D000792:Angiography; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D006801:Humans; D007249:Inflammation / Q000382:microbiology* / Q000473:pathology* / Q000601:surgery; D008297:Male; D009333:Neck / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D010406:Penicillins / Q000494:pharmacology*; D011182:Postoperative Care; D017703:Retropharyngeal Abscess / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D014057:Tomography, X-Ray Computed
chemical_list: D010406:Penicillins