Zygomatic haematoma in an 11-month-old helps diagnose retropharyngeal abscess, with concurrent tonsillitis and subsequent infant tonsillectomy

BMJ Case Rep. 2016 Sep 20:2016:bcr2016215135. doi: 10.1136/bcr-2016-215135.

Abstract

An 11-month-old boy presented with a 2-day history of non-specific symptoms and a zygomatic haematoma. With aetiology uncertain after admission clerking and blood tests, a CT head scan was arranged for suspected traumatic injury and revealed a retropharyngeal abscess (RPA) with significant airway narrowing in the transverse plane. The patient received urgent intraoral abscess drainage and bilateral tonsillectomy in theatre. This case highlights the need for a high index of suspicion regarding RPAs. These abscesses have potentially fatal sequelae and are difficult to diagnose in the infant paediatric population.

Publication types

  • Case Reports

MeSH terms

  • Acetaminophen / administration & dosage
  • Analgesics, Non-Narcotic / administration & dosage
  • Anorexia / etiology
  • Anti-Bacterial Agents / administration & dosage
  • Cefotaxime / administration & dosage
  • Dexamethasone / administration & dosage
  • Drainage
  • Hematoma / diagnostic imaging*
  • Hematoma / etiology*
  • Humans
  • Infant
  • Male
  • Metronidazole / administration & dosage
  • Postoperative Care
  • Retropharyngeal Abscess / complications*
  • Retropharyngeal Abscess / diagnostic imaging*
  • Retropharyngeal Abscess / surgery
  • Tomography, X-Ray Computed
  • Tonsillectomy*
  • Tonsillitis / complications
  • Tonsillitis / diagnostic imaging*
  • Tonsillitis / surgery*
  • Treatment Outcome
  • Vomiting / etiology

Substances

  • Analgesics, Non-Narcotic
  • Anti-Bacterial Agents
  • Metronidazole
  • Acetaminophen
  • Dexamethasone
  • Cefotaxime