Diagnosis of Retropharyngeal Abscess Section using Point of Care Ultrasound

Abstract

Point Of Care Ultrasound (POCUS) is a new concept and practice recently introduced into the clinical practice of medicine. It is commonly used by emergency and critical care physicians to help identify clinically significant as well as life-threatening pathologies. Retropharyngeal Abscess (RPA) can be presented in vague ways, and bedside Ultrasonography (USG) can aid in quick diagnosis, however it has been very rarely reported. This is a case report of a patient who presented with sore throat, fever and peritonsillar discharge. Neck USG showed a complex multi-loculated collection lateral to the thyroid gland and posterior to the right carotid artery (transverse view), a linear collection with anechoic center between the pharynx and cervical spine (longitudinal view), and a swirling phenomenon with respiration and swallowing as well as with carotid pulsation. CT scan showed retropharyngeal abscess with mediastinal extension. Possible aetiologies include spread from tonsillitis, dental abscess, pharyngeal or upper respiratory infection. It was treated with antibiotics and surgical drainage. The patient made a good recovery, and the collection resolved on repeat CT imaging.

Keywords

• diagnostic imaging
• parapharyngeal abscess
• pharyngitis
• ultrasonography