MyPACS.net: Radiology Teaching Files > Case 13907234

previously visited 080311 NECK CELLULITIS, SUSPICIOUS RETROPHARYNGEAL ABSCESS
Contributed by: pedrad CSH, Radiologist, Chung Shan Medical University Hospital, Taiwan.
Patient: 3 month old male
History:

Chief complain:
Fever and cyanosis since yesterday.
Erythematous change over neck (+).
Poor appetite (+), decreased activity (+), tachycardia (170 beats/ min.)
No obvious skin wound
His sister has cellulitis over leg

Birth history:
G6P4AA1SA1
Gestational age: 37+2 weeks, C/S
Birth body weight: 3000 gm

Laboratory data:
WBC: 6990 /mm3 (Band 14%, Seg 67%, Lymho 17%).

Images:[small]larger

Fig. 1: CT scan with IV contrast

Fig. 2: CT scan with IV contrast

Fig. 3: CT scan with IV contrast, sagittal reconstruction
Findings:

CT scan of neck with pre- and post- intravenous contrast, and
 with multiplanar reconstruction:

1. Abnormal fluid infiltration along bilateral neck, chiefly along
   left posterior cervical space (red arrow in figure 2), with
   adjacent bilateral subcutaneous fat stranding (yellow arrows in
   figure 1 and 2), compatible with cellulitis.
   Presence of mass effect of the lesion with vascular smooth
   narrowing along left jugular vein (green arrow in figure 1),
   suggesting vascular compression.
2. Focal fluid accumulation in midline retropharyngeal space
   (blue arrows in figure 1, 2, and 3) with indentation of
   posterior wall of airway from oropharyngeal region
   to superior mediastinum, retropharyngeal abscess can not be
   excluded.

Impression:
1. Cellulitis along bilateral neck, suspicious retropharyngeal
   abscess.

Diagnosis: Neck cellulitis suspicious retropharyngeal abscess
(Blood culture: Streptococcus pyogenes)
Discussion: <Progress Note>
The patient received antibiotic treatment without fluid aspiration.
Comments:
No comments posted.
Additional Details:

Case Number: 13907234Last Updated: 03-20-2008
Anatomy: Face and Neck   Pathology: Infection
Modality: CTAccess Level: Readable by all users
Keywords: cellulitis, retropharyngeal abscessACR: 28.2013

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