Pharyngitis with Perforated Suppurative Retropharyngeal Adenitis and Retropharyngeal Abscess, CT
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0133-Pharyngitis with Perforated Suppurative Retropharyngeal Adenitis and Retropharyngeal Abscess,
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CA0133-Pharyngitis with Perforated Suppurative Retropharyngeal Adenitis and Retropharyngeal Abscess,
Case ReportHistory
Exam
Findings
Nasopharynx Including Retropharyngeal Lymph Nodes
The nasopharynx appears generally normal for the patient’s age. There is some parapharyngeal and retropharyngeal edema.
Oropharynx
There is extensive edema/cellulitis on the posterior pharyngeal wall and throughout the retropharyngeal and parapharyngeal space at the level of the oropharynx.
Retropharyngeal Lymph Nodes:
There are left-sided suppurative retropharyngeal lymph nodes that have perforated to produce an abscess on the level of the oropharynx, with maximum short axis diameter of the suppurative node measuring 3 cm x 2.5 cm with a craniocaudal diameter of 3.5 cm. The left oropharyngeal wall is displaced with moderate narrowing of the oropharyngeal airway.
There is surrounding edema in the retropharyngeal space on the level of the oro- and hypopharynx.
There is reactive retropharyngeal lymphadenopathy on the right, without evidence of suppuration.
Hypopharynx, larynx, deep neck and entire retropharyngeal space
There is extensive edema involving the hypopharynx the muscles of the visceral compartment and the adjacent deep neck down to the level of the esophageal verge or at least the lower hypopharynx.
The retropharyngeal abscess from this perforated suppurative retropharyngeal lymph node extends inferiorly to the level of the mid-neck. The abscess appears to be possibly loculated. There is edema but no abscess in the adjacent prevertebral and paravertebral spaces.
Major Salivary Glands
There is no significant abnormality of the parotid, submandibular or sublingual glands that would be an alternative explanation for the patient’s symptoms.
Other Cervical Lymph Nodes:
There is reactive cervical lymphadenopathy bilateral in level 2, 3 and 5.
Vascular Findings
There is no evidence of thrombus, thrombophlebitis or other occlusive or inflammatory process of the jugular vein or smaller venous tributaries. There is no evidence of inflammation of the common, external or internal carotid artery.
The remainder of the study is normal for the patient’s age.
