11) We found an interesting case report in the literature about
parapharyngeal abscess (PPA)-like lesion in a 3 years old boy in Asia.
She was investigated for retropharyngeal and
parapharyngeal abscess, granulomatosis with polyangiitis, tuberculosis and thyroiditis but finally concluded as Lemierre's syndrome based on the findings of thrombosis of the deep neck veins following respiratory tract infection, septic pulmonary emboli and clinical recovery with antibiotics and supportive care.
In this clinical study of 40 patients with deep neck space infections, the commonest was the
parapharyngeal abscess (37.
The third visit led to an inpatient admission with administration of intravenous antibiotics and steroids for a suspected
parapharyngeal abscess.
This showed a small right
parapharyngeal abscess, thrombosis of the right internal jugular vein (Figure 1), and multiple peripheral lung nodules, expression of septic embolization (Figures 2(a), 2(b), and 2(c)).
Temporal bone fibrous dysplasia and cholesteatoma leading to the development of a
parapharyngeal abscess.
The incidence of
parapharyngeal abscess has reduced dramatically, with the evolution of antibiotics.
9) Diabetes is the most common systemic condition predisposing one to
parapharyngeal abscess.
Twelve had concomitant
parapharyngeal abscess and one had concomitant peritonsillar abscess.
Table 2: Diagnosis Vs Gender Diagnosis Male % Female % Ludwig's angina 35 52% 4 22% Peritonsillar abscess 8 12% 0 Parotid abscess 11 16% 6 33%
Parapharyngeal abscess 3 4% 7 39% Retro Pharyngeal abscess 6 9% 1 6% Necrotizing fasciitis 4 6% 0
In view of the size and position of the mass, urgent computed tomography (CT) of the neck was obtained in order to exclude a
parapharyngeal abscess.
The combination of a
parapharyngeal abscess and torticollis due to spastic contractions of the sternocleidomastoid muscle is an extremely rare condition.
