An atypical pathway of infection in an adolescent with a deep neck space abscess.

D eep neck space infections are a potential complication of odontogenic infection, but rarely have been reported in children. In a recent study, 113 pediatric patients were hospitalized with maxillofacial infections with 32 from dental sources; however, the extension of these infections into deep neck spaces was not documented. 1 In a similar study of 67 children with abscess of the head and neck, only 15 cases were determined to have submandibular, lateral pharyngeal, or retropharyngeal space involvement, and only nine were attributed to dental infection. 2 Lateral pharyngeal space infections are more commonly odontogenic in adults; in contrast, the likely predisposing factors in children are nasopharyngitis or adenoiditis. 3 Eight pediatric patients with lateral pharyngeal space infections were identified by Broughton, 4 but no etiological determinations were given. Early diagnosis and treatment of lateral pharyngeal infections are essential because further progression of infection can be rapid. Severe trismus, limiting direct examination of the oropharyngeal region, often complicates clinical evaluation. In addition, the limited value of conventional roentgenograms in locating the involved deep neck spaces makes definitive diagnosis difficult. This case report describes a 14-year-old African-American female who developed a left peritonsillar and lateral pharyngeal abscess from an odontogenic source. She was managed successfully with appropriate antibiotics and surgical intervention after diagnosis using computerized tomography (CT).