IJOHNS  Vol.2 No.6 , November 2013
Giant Retropharyngeal Abscess in a Nigerian Adult Following Fish Bone Throat Injury
ABSTRACT
Retropharyngeal abscess (RPA) is an uncommon disease entity that typically occurs in children under 5 years of age, which has the potential to cause upper airway obstruction. Upper respiratory tract infection is the most common predisposing factor to RPA in children while cervical spine tuberculosis and trauma are the major aetiological factors in the adult. We report a case of a 21-year-old Nigerian farmer with giant retropharyngeal abscess following fish bone throat injury causing life-threatening upper airway obstruction. The patient responded well to emergency tracheostomy, intraoral surgical drainage and empirical antibiotic therapy. We highlight the diagnostic and therapeutic challenges of managing such a patient.

Cite this paper
S. Amutta, D. Aliyu, M. Abdullahi, M. Danfulani and Y. Mufutau, "Giant Retropharyngeal Abscess in a Nigerian Adult Following Fish Bone Throat Injury," International Journal of Otolaryngology and Head & Neck Surgery, Vol. 2 No. 6, 2013, pp. 271-275. doi: 10.4236/ijohns.2013.26056.
References
[1]   B. Hartley, “Cervicofacial Infection in Children,” In: G. Michael, Ed., Scott’s Browns Otorhinolaryngology, Head and Neck Surgery, 7th Edition, Hodder Arnold, London, 2008, pp. 1213-1214.
http://dx.doi.org/10.1201/b15118-107

[2]   L. W. Tom and I. N. Jacobs, “Diseases of the Oral Cavity, Oropharynx, and Nasopharynx,” In: B. James, Ed., Ballenger’s Otorhinolaryngology, Head and Neck Surgery, 16th Edition, BC Decker Inc., Hamilton, 2003, pp. 1039-1040.

[3]   C. Ozbek, S. Dagli, E. E. U. Tuna, O. Ciffci and C. Ozdem, “Giant Retropharyngeal Abscess in an Adult as a Complication of Acute Tonsillitis: Case Report,” Ear Nose Throat Journal, Vol. 88, No. 11, 2009, p. E20.

[4]   S. B. Sharma and P. Hong, “Ingestion and Pharyngeal Trauma Causing Secondary Retropharyngeal Abscess in Five Adult Patients,” Case Report in Emergency Medicine, Vol. 2012, 2012, Article ID: 943090.

[5]   O. A. Afolabi, J. O. Fadare, E. O. Oyewole and S. A. Ogah, “Fish Bone Foreign Body Presenting with an Acute Fulminating Retropharyngeal Abscess in a Resource-Challenge Centre: A Case Report,” Journal of Medical Case Reports, Vol. 5, 2011, p. 165.
http://dx.doi.org/10.1186/1752-1947-5-165

[6]   A. Harkani, R. Hassani, T. Ziad, L. Aderdour, H. Nouri, Y. Rochdi and A. Raji, “Retropharyngeal Abscess in Adults: Five Case Reports And Review of the Literature,” The Scientific World Journal, Vol. 11, 2011, pp. 1623-1629. http://dx.doi.org/10.1100/2011/915163

[7]   E. Mevio, P. Calabro, F. De Paoli, A. Maccabruni and G. Michelone, “Unusual Extracranial Complications of Otitis Media in a Young HIV Patient: Retropharyngeal and Mouret’s Abscess,” Revue de Laryngologie-Otologie-Rhinologie, Vol. 119, No. 3, 1998, pp. 199-201.

[8]   R. Meyer, S. Argarwal and I. Singh, “Tuberculous Retropharyngeal Abscess in an HIV Patient,” Hong Kong Medical Journal, Vol. 12, No.6, 2006, pp. 483-485.

[9]   O. G. Nwaorgu, P. A. Onakoya, J. A. Fasunla and T. S. Ibekwe, “Retropharyngeal Abscess: A Clinical Experience at the University College Hospital Ibadan,” Nigeria Journal of Medicine, Vol. 14, No. 4, 2005, pp. 415-418.

[10]   C. R. Jennings, “Surgical Anatomy of the Neck,” In: G. Michael, Ed., Scott’s Browns Otorhinolaryngology, Head and Neck Surgery, 7th Edition, Vol. II, Hodder Arnold, London, 2008, pp. 1744-1745.
http://dx.doi.org/10.1201/b15118-153

[11]   I. Brook, “Microbiology and Management of Peritonsillar, Retropharyngeal Abscess and Pharyngeal Abscesses,” Journal of Oral & Maxillofacial Surgery, Vol. 62, No. 12, 2004, pp. 1545-1550.
http://dx.doi.org/10.1016/j.joms.2003.12.043

[12]   G. J. Ridder, K. Technau-Ihling, A. Sander and C. C. Boedeker, “Spectrum and Management of Deep Neck Space Infections: An 8-Year Experience of 234 Cases,” Otolaryngology—Head and Neck Surgery, Vol. 133, No. 5, 2005, pp. 709-714.
http://dx.doi.org/10.1016/j.otohns.2005.07.001

[13]   J. Stalfors, A. Adielsson, A. Ebenfelt, G. Nethander and T. Westin, “Deep Neck Space Infections Remain a Surgical Challenge. A Study of 72 Patients,” Acta Otolaryngology, Vol. 124, No. 10, 2004, pp. 119-1196.
http://dx.doi.org/10.1080/00016480410017864

[14]   K. Terao, T. Kusunoki, K. Mori. K. Murata and K. Doi, “A Case of Calcific Retropharyngeal Tendinitis: The Significance of Early Diagnosis,” Ear, Nose and Throat Journal, Vol. 92, No. 2, 2013, pp. 74-83.

[15]   P. J. Schuller, M. Cohen, J. Greve, C. Plettenberg, J. Chereath, M. Wagemann, et al., “Surgical Management of Retropharyngeal Abscess,” Acta Oto-Laryngologica, Vol. 129, No. 11, 2009, pp. 1274-1279.
http://dx.doi.org/10.3109/00016480802642088

[16]   D. K. C. Wong, C. Brown, N. Mills, P. Spielmann and M. Neeff, “To Drain or Not to Drain-Management of Pediatric Deep Neck Abscesses: A Case Conrol Study,” International Journal Pediatric Otorhinolaryngology, Vol. 76, No. 12, 2012, pp. 1810-1813.
http://dx.doi.org/10.1016/j.ijporl.2012.09.006

[17]   K. Chang, Y. Chen, S. Hao and S. Chen, “Ultrasound-Guided Closed Drainage for Abscesses of the Head and Neck,” Otolaryngology—Head and Neck Surgery, Vol. 132, No. 1, 2004, pp. 119-124.
http://dx.doi.org/10.1016/j.otohns.2004.08.004

[18]   M. P. Kamath, K. M. Bhojwani, S. U. Kamath, C. Mahabala and S. Argawal, “Tuberculous Retropharyngeal Abscess,” Ear Nose Throat Journal, Vol. 86, No. 4, 2007, pp. 236-237.

[19]   H. A. Soub, “Retropharyngeal Abscess Associated with Tuberculosis of Cervical Spine,” Tubercle and Lung Disease, Vol. 77, No. 6, 1996, pp. 563-565.
http://dx.doi.org/10.1016/S0962-8479(96)90057-X

[20]   A. Christoforidou, S. Metallidis, P. Kollaras, A. Agathangelidis, P. Nikolaidia, V. Vital and K. Markou, “Tuberculous Retropharyngeal Abscess as a Cause of Oropharyngeal Dysphagia,” American Journal of Otolaryngology-Head and Neck Medicine and Surgery, Vol. 33, No. 2, 2012, pp. 272-274.

[21]   C. Patil, R. Kharat, P. Deshmukh, S. Singhal and B. D’Souza, “Tuberculous Retropharyngeal Abscess without Cervical Spine TB,” Asian Pacific Journal of Tropical Medicine, Vol. 4, No. 3, 2011, pp. 251-252.
http://dx.doi.org/10.1016/S1995-7645(11)60080-1

[22]   H. S. Sharma, D. S. Kurl and M. Hamza, “Retropharyngeal Abscess: Recent Trend,” Auris Nasus Larynx, Vol. 25, No. 4, 1998, pp. 403-406.
http://dx.doi.org/10.1016/S0385-8146(98)00007-8

 
 
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