Microbiological Profile of Acute Retropharyngeal Abscesses in Children : Analysis of 26 Egyptian Patients

Abstract

Objectives: this work aims to describe our experience in a tertiary centre for the diagnosis of acute retropharyngeal abscesses in children as regards the diagnosis, microbiological analysis and their management. Methodology: A prospective study that included 26 patients suffering from acute retropharyngeal abscess in children was done for a period of about 3 years from September 2011 to July 2014 on pediatric patients. CT was used for diagnosis of the abscess. Twenty patients were underwent surgical drainage of the abscess. Pus was aspirated from all patients and used for microbiological analysis. Data for clinical presentation, X-ray, CT scan findings, bacteriological profile and management of the cases were collected. Results: 26 patients were investigated in this study. Males were more commonly affected than females. Their ages ranged from 8month to 12 years (mean ± 5.45 years). The most common symptoms at time of investigation were fever followed by dysphagia/odynophagia and neck swelling. The most common clinical sign was cervical lymphadenopathy. Positive microbial cultures were detected in 84.6%. Polymicrobial growth was recorded in 34.6%. The most common isolated organism was MRSA (38.5 %) followed by Staphylococcus aureus (26.9%) and Pseudomonas aeruginosa (19.2%). Conclusion: The used antibiotics in the retropharyngeal abscesses to be used should cover mainly Gram positive bacteria especially MRSA. This may substitute surgical intervention in many cases. MRSA found to be a rising causative agent of acute retropharyngeal abscess in children in our locality. Obtaining samples may be difficult for microbiological culture. Antibiotics should be prescribed immediately according to the antibiotic guide in each locality to reduce the morbidity rate of the acute retropharyngeal abscess.