Retropharyngeal abscess due to Staphylococcus aureus complicated by bilateral neck and intraabdominal abscesses in an immunocompetent infant

Retropharyngeal abscess is a serious condition, with potentially high morbidity and mortality if not detected early. The patient, a previously healthy 10-month-old girl, was admitted due to retropharyngeal and bilateral cervical lymph node abscesses. The neck abscesses recurred, despite surgical drainage and treatment with intravenous ampicillin-sulbactam. Methicillin-susceptible Staphylococcus aureus was identified from the abscess culture. A mesenteric abscess was also found during treatment. Intravenous ampicillin-sulbactam was switched to intravenous cephazolin and metronidazole, and the patient was successfully treated without further surgical intervention. No recurrence was observed throughout the 1-year follow-up period. Immune function testing, especially neutrophil function, did not reveal any abnormality. Neck abscesses can spread to the deep or shallow neck spaces directly or through the lymph node chains, even in immunocompetent hosts. Clinicians should consider deep neck infection in patients with cervical lymph node abscess, even if they present without the typical signs and symptoms of retropharyngeal abscess.