Pharyngitis, peritonsillar abscess, and retropharyngeal abscess (pediatrics) Quiz: Ace Your Exams
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A 4-year-old boy is brought to the emergency department for evaluation of a sore throat and neck pain. The patient had a viral upper respiratory tract infection one week ago and was recovering well, but over the past day, he developed pain and difficulty with swallowing, fever, and a muffled and hoarse voice. The patient is otherwise healthy and is up-to-date on immunizations. Temperature is 39°C (102°F), blood pressure is 110/56 mmHg, pulse is 121/min, respiratory rate is 22/min, and oxygen saturation is 98% on room air. The patient is anxious but is not in respiratory distress. He refuses to extend his neck secondary to pain and will only minimally flex his neck and rotate it. Examination of the posterior pharynx reveals swelling without tonsillar enlargement. Bilateral tender cervical lymphadenopathy is present. Cardiopulmonary examination is within normal limits. Which of the following findings indicates the need for advanced imaging?
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