Guidelines
Retro/Para Pharyngeal Cellulitis/Abscess

Retro/Para Pharyngeal Cellulitis/Abscess

Clinical/Diagnostic Considerations

  • Assess for airway obstruction
  • Peak age 2-4 years
  • Older child/adolescent with severe illness and neck pain, consider jugular venous septic phlebitis (Lemierre's syndrome) caused by Fusobacterium.
  • Drooling, neck extension, consider epiglottitis
  • Imaging (x-ray +/- CT/MRI), throat swab, blood cultures

Infection Prevention and Control

Droplet / Contact Precautions

Until 24 hours of appropriate antimicrobial therapy

Empiric Antimicrobials

Covers GAS, most upper airway anerobes

OR

Provides additional coverage for S. aureus

If severe illness, respiratory tract obstruction, possible epiglotitis or unimmunized

If severely ill patient or suspected venous thrombosis, add

Follow Up

Once improved, afebrile convert to corresponding oral agent.

Spectrum may be narrowed to a more specific agent if cultures yield a specific pathogen (e.g. GAS)

Usual Duration

10 days