A child presents to the ED with malaise, fever and torticollis. He is drooling and has odynophagia and dysphagia. He has a muffled voice.
Concern for deep neck infection. Epiglottitis? Retropharyngeal Space Infection?
Neck CT:
There is a peripherally enhancing collection associated with an enlarged lateral retropharyngeal lymph node on the left. This represents a suppurative adenitis. There is a low density collection within the adjacent retropharyngeal space with extensive inflammatory stranding. The pharyngeal tonsils (Adenoids) and palatine tonsils are enlarged. The left palatine tonsil is displaced anteriorly. There is reactive adenopathy within the neck.
Airway management and antibiotics with or without surgical debridement.
Ludwig angina.
https://radiopaedia.org/articles/ludwig-angina?lang=us