A 3-year-old child presents with high fever, neck stiffness, dysphagia, drooling, and a muffled voice for 3 days. CT scan with contrast shows a hypodense collection with rim enhancement in the retropharyngeal space. What is the most appropriate management?
- A Needle aspiration or surgical drainage with intravenous antibiotics ✓
- B Intravenous antibiotics alone
- C Observation with antipyretics
- D Intravenous corticosteroids
Correct answer: A. Needle aspiration or surgical drainage with intravenous antibiotics
Explanation
Retropharyngeal abscess requires drainage via needle aspiration or surgical incision along with intravenous antibiotics. Antibiotics alone are insufficient once an abscess has formed. The condition can progress to airway obstruction, mediastinitis, or aspiration pneumonia if not drained promptly.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
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