ABSTRACT

This study aims to review the computed tomography (CT) findings in children with deep neck infections. The crucial role of CT in the diagnosis is emphasized.

Contrast enhanced CT images and medical records of twelve children (4 girls, 8 boys, age range: 1-14 years, mean age: 9) diagnosed with deep neck infection were retrospectively evaluated. Positive CT findings of deep neck infection were: cellulitis, increased fatty tissue echogenicity, loss of soft tissue planes, myositis, and necrotic lymphadenopathy; presence of phlegmon, peritonsillar, retropharyngeal or parapharyngeal abscess. The first four findings were considered as ‘early findings’ while the presence of an abscess indicated advanced infection and was solely enough to make a diagnosis.

42% of the children with deep neck infections had necrotic cervical lymphadenopathies. 5 children (52%) had cellulitis, 11 (92%) had increased fatty tissue dansity, and 6 (50%) children had myositis. Deep neck abscesses (3 retropharyngeal, 4 parapharyngeal, 2 peritonsillar) were depicted in 7 children and phlegmon in one child. 2 patients had combined parapharyngeal/retropharyngeal abscesses. The most frequent type was parapharyngeal abcess.

CT imaging has a crucial role in the diagnosis and follow-up of deep neck infections in children and is the preferred modality of choice.