Management of paediatric retropharyngeal infections: non-surgical versus surgical.

BACKGROUND: Paediatric retropharyngeal infections are a serious infection associated with morbidity. The relative role of medical versus surgical treatment for these infections is debated. The aims of this study were to analyse the management of retropharyngeal infections with respect to radiological assessment and treatment.

METHODS: Medical records from January 1999 to June 2005 were reviewed and analysed.

RESULTS: Twenty-four children with retropharyngeal infections were included in the study. Computed tomography had a 75% accuracy of correctly identifying an abscess and 36% of the retropharyngeal abscesses resolved with medical treatment alone, with no difference in duration of hospital stay or morbidity.

CONCLUSION: Medical treatment of retropharyngeal abscesses has been successful in selected cases. We can recommend this as a viable alternative to surgery and would suggest a 48-h inpatient i.v. antibiotic trial in selected children before considering surgery.