Podcast #315: Retropharyngeal Infections in Pediatrics

Podcast #315: Retropharyngeal Infections in Pediatrics

Author: Dr. Karen Woolf, MD

Educational Pearls:

  • Anatomy : base of skull to posterior mediastinum, anteriorly bounded by middle layer of deep cervical fascia and posteriorly by the deep layer, communicates to lateral pharyngeal space bounded by carotid sheath. Lymph node chains draining nasopharynx, sinuses, middle ear, etc. run through it.
  • Epidemiology & Microbiology: most common kids 2-4, (neonates too). Polymicrobial (GAS, MSSA, MRSA, respiratory anaerobes).
  • Signs and symptoms can include pharyngitis, dysphagia, odynophagia, drooling, torticollis, muffled voice, respiratory distress, stridor, neck swelling, and trismus.
  • Exam may show drooling, posterior pharyngeal swelling, anterior cervical LAD, or a neck mass.
  • Imaging: Get CT neck w/IV contrast!
  • DDx: epiglottis, croup, bacterial tracheitis, peritonsillar abscess, trauma, foreign body, angioedema, cystic hygroma, meningitis, osteomyelitis, tetanus toxin.
  • Tx: Unasyn, if not responding add Vancomycin or Linezolid; surgical drainage if airway is compromised.
  • Complications: airway obstruction, sepsis, aspiration pneumonia, IJ thrombosis, carotid artery rupture, mediastinitis.

References:

Craig FW, Schunk JE. Retropharyngeal abscess in children: clinical presentation, utility of imaging, and current management. Pediatrics 2003; 111:1394.

Fleisher GR. Infectious disease emergencies. In: Textbook of Pediatric Emergency Medicine, 5th ed, Fleisher GR, Ludwig S, Henretig FM (Eds), Lippincott Williams & Wilkins, Philadelphia 2006. p.783.

Goldstein NA, Hammersclag MR. Peritonsillar, retropharyngeal, and parapharyngeal abscesses. In: Textbook of Pediatric Infectious Diseases, 6th ed, Feigin RD, Cherry JD, Demmler-Harrison GJ, Kaplan SL (Eds), Saunders, Philadelphia 2009. P.177

Jaksot(1147)

Podcast 740: Placenta Previa

Podcast 740: Placenta Previa

Contributor: Peter Bakes, MD Educational Pearls: High concern causes of third trimester vaginal bleeding include placenta previa, placental abruption, or vasa previa In placenta previa, the placenta ...

21 Joulu 20213min

Podcast 739: Perceptions of Dress

Podcast 739: Perceptions of Dress

Contributor: Aaron Lessen, MD Educational Pearls: Study examined patient perceptions of providers wearing traditional white coats,  fleece coats and soft-shell jackets Found that white coats were see...

20 Joulu 20213min

Podcast 738: Acute Mesenteric Ischemia

Podcast 738: Acute Mesenteric Ischemia

Contributor: Ian Gillman, PA-C Educational Pearls: Acute mesenteric ischemia is a condition where bowel loses blood supply from an acute occlusion of the mesenteric arteries A frequent sign is abdomi...

14 Joulu 20212min

Podcast 737: TBI Outcomes

Podcast 737: TBI Outcomes

Contributor: Aaron Lessen, MD Educational Pearls: Study evaluating patient outcomes after traumatic brain injury (TBI) over 1 year Trial followed patients with severe TBI (GCS 3-8) and moderate TBI (...

13 Joulu 20212min

Podcast 736: Seasonal Affective Disorder

Podcast 736: Seasonal Affective Disorder

Contributor: Adam Barkin, MD Educational Pearls: Seasonal Affective Disorder (SAD) a form of seasonal depression which can result in trouble sleeping, concentration difficulties, changes in appetite,...

7 Joulu 20213min

Podcast 735: End Tidal CO2 and BiPAP

Podcast 735: End Tidal CO2 and BiPAP

Contributor: Aaron Lessen, MD Educational Pearls: End tidal CO2 is accurate to 1-4 mmHg in intubated patient but use with those on positive pressure ventilation like BiPAP is unclear Study looked at ...

6 Joulu 20212min

Podcast 734: Push Dose Antibiotics

Podcast 734: Push Dose Antibiotics

Contributor: Aaron Lessen, MD Educational Pearls: Recent study at a hospital in Chicago with a shortage of normal saline decided to push IV ceftriaxone rather than the typical infusion of the antibio...

1 Joulu 20212min

Podcast 733: Nitric Oxide for COVID

Podcast 733: Nitric Oxide for COVID

Contributor: Nick Hatch, MD Educational Pearls: Inhaled nitric oxide or Flolan may be considered in COVID Flolan is a prostaglandin can be inhaled or given IV These medications are classically us...

30 Marras 20215min

Suosittua kategoriassa Tiede

rss-poliisin-mieli
rss-mita-tulisi-tietaa
tiedekulma-podcast
docemilia
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-duodecim-lehti
radio-antro
utelias-mieli
filocast-filosofian-perusteet
rss-lapsuuden-rakentajat-podcast
rss-lihavuudesta-podcast
rss-sosiopodi