Pediatric Parapharyngeal Abscess

  • Etiology: Deep neck abscess in parapharyngeal space usually secondary to oropharyngeal infection that spreads by direct continuity or lymphatic drainage
  • Imaging: Abscess in parapharyngeal space
  • DDX:
  • Complications:
    — Acute laryngeal edema and airway obstruction
    — Spread of infection to retropharyngeal space
    — Spread of infection to mediastinum along carotid space or danger space
    — Thrombophlebitis of jugular vein
    — Mycotic aneurysm with possible rupture of internal carotid artery
  • Treatment: Antibiotics and surgical drainage
  • Clinical:

Radiology Cases of Parapharyngeal Abscess

CT of parapharyngeal abscess
Axial CT with contrast of the neck shows a round, well circumscribed, low density lesion in the left parapharyngeal space that has mild peripheral enhancement.
CT of parapharyngeal abscess
Axial CT with contrast of the neck shows a round low density fluid collection with a thin enhancing rim in the right parapharyngeal space. The right carotid artery and right internal jugular vein are narrowed in caliber and there is mass effect on the right side of the airway.