Retropharyngeal abscess in children: 10-year study.

OBJECTIVE Retrospective analysis of all patients treated for retropharyngeal infection in a tertiary care pediatric hospital. METHODS Charts were reviewed for demographic data, duration of symptoms, radiologic workup, antibiotic choice, microbiologic findings, surgical approach, complications, and duration of medical therapy. Surgical findings were correlated with computed tomographic (CT) scans. RESULTS Sixty-eight patients were included in the study. Empirical intravenous clindamycin was started for a trial of conservative medical therapy. Fifty-one patients (75%) responded to medical treatment, and only 17 patients (25%) required surgical intervention. The CT scan showed a sensitivity of 43% and a specificity of 63% in this series. None of the patients with retropharyngeal infection died, had a major complication, or had a recurrence. CONCLUSION Based on the current study, we propose that all patients should be given a trial of medical treatment with intravenous clindamycin. Surgery should be reserved for those who do not respond. An extensive review of the literature is presented.