Pediatric Danger Space Abscess

  • Etiology:
    — Retropharyngeal space extends from skull base to T2
    — Danger space is posterior to retropharyngeal space and extends from skull base to diaphragm
    — Prevertebral space is posterior to danger space and extends from skull base to coccyx
    — So danger space abscess is deep neck collection extending into mediastinum and below T2
  • Imaging: Abscess in danger space
  • DDX:
  • Complications: Abscess in danger space can cause descending necrotizing mediastinitis, jugular vein thrombophlebitis or thrombosis, carotid artery rupture, pericarditis or cardiac tamponade, bronchial erosion or pyopneumothorax
  • Treatment: Antibiotics
  • Clinical:

Radiology Cases of Danger Space Abscess

CT of retropharyngeal abscess extending into mediastinum
Axial (upper), coronal (lower left) and sagittal (lower right) CT with contrast of the neck shows a low density fluid collection in an enlarged retropharyngeal space that extends inferiorly deep into the mediastinum, best seen on the sagittal image.