Demographics:
9 months old, Female
Indication:
Fever, concern for retropharyngeal abscess
Findings
- Peripherally enhancing collection in the left neck centered near the carotid space
- Ill/defined fluid extends within the carotid sheath inferiorly into the upper mediastinum without well-defined mediastinal collection, though the mediastinum is incompletely evaluated
- Retropharyngeal edema without retropharyngeal abscess
- Mass effect upon and narrowing of the oropharynx and left internal jugular vein, both of which remain patent
- Reactive cervical lymphadenopathy
Diagnosis
Suppurative lymphadenitis with descending mediastinitis
Sample Report
Left neck abscess measuring 2.5 x 2 x 2.5 cm centered near the carotid space with inferior extension through the carotid sheath into the upper mediastinum, consistent with descending mediastinitis. No well-formed superior mediastinal abscess, though the mediastinum is incompletely evaluated. Consider chest CT with contrast to further evaluate the extent of infection. Mass effect on the oropharynx and left internal jugular vein, both of which remain patent.
Retropharyngeal edema without abscess.
Reactive cervical lymphadenopathy.
Discussion