Absceso retrofaríngeo en niños con fiebre y dolor de garganta ¿cómo actuar?

Title: Retrofaringeal Abscess in Children with Fever and Sore Throat: What to Do? Profile: Fever and sore throat in children may indicate a retrofaringeal abscess, an emergency that requires urgent medical attention. Keywords: ['Pediatrics', 'Emergency'] Author: Liu Yingting, Pediatric Department, Second People's Hospital of Hunan Province (Provincial Neurosurgery Hospital).

Doctor, my child has a sore throat and a fever close to 40 degrees Celsius, she cannot even drink water. Recently, a 3-year-old girl, Xiao Yu (pseudonym), came to the pediatrics department of the Second People's Hospital of Hunan Province (Provincial Neurosurgery Hospital) due to throat and neck pain as well as recurrent fevers. After several tests, it was discovered that she had a retrofaringeal abscess.

In the pediatrics consultation, not few children present these conditions. Many think it is just a tonsil inflammation, unaware that an emergency called retrofaringeal abscess could be lurking. Dr. Xu Lin, a pediatric specialist, emphasizes that the retrofaringeal abscess is like a ticking time bomb hidden in the respiratory tract; if diagnosis and treatment are delayed, it can lead to life-threatening risks such as asphyxia or septicemia.

The retrofaringeal abscess is a purulent infection in the retrofaringeal space, usually caused by bacteria such as beta-hemolytic streptococcus or golden staphylococcus. Children are a high-risk group due to the abundance of lymphatic tissue in the pharynx, their still-developing immune system, and the frequent presence of infection foci such as tonsillitis and cavities.

The initial symptoms of a retrofaringeal abscess are very similar to those of an upper respiratory tract infection, which can lead to misdiagnosis. However, as the disease progresses, a series of characteristic manifestations appear that parents should pay special attention to:

First, the pain "is not normal": the sore throat is intense and concentrated on one side, increasing when swallowing, and may radiate to the ear; in severe cases, swallowing becomes impossible and saliva can only flow outward.

Second, difficulty in opening the mouth and lack of clarity in speech: patients with peritonsillar abscess may experience "restriction in opening the mouth", and when speaking it seems they have something in their mouth, with unclear voice.

Third, persistent high fever: generally refers to a temperature above 39 degrees Celsius. The use of common antipyretic medications has little effect and is accompanied by symptoms of systemic infection such as fatigue and decreased appetite.

Fourth, abnormalities in the neck: notable enlargement and tenderness of lymph nodes on one side of the neck; in some patients, swelling in the neck may appear, and the pain increases when turning the head.

Fifth, breathing alterations: when an abscess presses on the airways, rapid and difficult breathing may occur. In infants, this may manifest as the sign of the "three excavations", which is a sign of asphyxia and requires immediate medical attention.

In treatment, if the patient shows breathing difficulty or signs of asphyxia, an immediate tracheotomy or cricothyroid puncture should be performed, prioritizing ensuring airway patency, as this is key to saving lives.

Xu Lin reminds that preventing peritonsillar abscess is more important than treatment. Remember these 4 points:

1. Timely treatment of basic infections: it is necessary to thoroughly treat foci of infection such as tonsillitis, pharyngitis, cavities, and otitis media to prevent bacteria from spreading to the retrofaringeal space.

2. Increase immunity: children should ensure adequate sleep, maintain a balanced diet, and engage in outdoor activities frequently; during flu season, it is advisable to avoid crowded places and wear a mask.

3. Adopt good habits: rinse your mouth after meals, brush your teeth in the morning and at night, and maintain oral hygiene; avoid excessive voice use, and when you have a sore throat, consume fewer spicy and hard foods to reduce throat irritation.

4. Avoid self-medication: Antibiotics or "home remedies" should not be taken indiscriminately in case of sore throat. If the pain persists for more than three days and worsens, or if high fever or difficulty in opening the mouth appears, seek medical attention immediately.

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