Febrile torticollis in an infant: what is your diagnosis?

Abstract

Retropharyngeal abscess is a rare but serious infection, in children, it is often secondary to upper respiratory tract infections.We report the case of an 18-month-old infant admitted to the emergencies for acute febrile torticolis. A computed tomographic (CT) scan with contrast agent injection revealed a collection of the retropharyngeal space; management consisted of triple antibiotic therapy and transoral drainage. The evolution was made towards a clinical and biological improvement. Retropharyngeal abscess should be suspected in front of dysphagia, cervical stiffness associated with a febrile syndrome, CT scan confirms the diagnosis and early management by intravenous antibiotic therapy whether or not combining surgical drainage, which remains a subject of discussion. Early diagnosis and management help to avoid life-threatening complications.