key: cord-0060800-qkbzz4l7 authors: Domachowske, Joseph; Suryadevara, Manika title: Pharyngitis and Pharyngeal Space Infections date: 2020-08-06 journal: Clinical Infectious Diseases Study Guide DOI: 10.1007/978-3-030-50873-9_7 sha: a71b2f91216fe77a45be0fa0589913c330c1f1bf doc_id: 60800 cord_uid: qkbzz4l7 A 17-year-old female is seen in the emergency department with a 2-day history of fevers to 103 °F and a sore throat. Today, she describes her pain to be severe and mostly on the right side. She complains of difficulty opening her mouth and pain with swallowing. On examination, she appears anxious and uncomfortable, speaking softly with a muffled voice. Her oropharyngeal exam, although difficult to perform because of moderate trismus, reveals pharyngeal erythema, right pharyngeal wall swelling with deviation of her uvula to the left. Right neck swelling is also appreciated. A contrast-enhanced CT scan shows a peritonsillar abscess. Intravenous administration of ampicillin-sulbactam is initiated. An otolaryngology consult is obtained, and incision and drainage of the abscess is performed at the bedside. She is discharged home with oral amoxicillin-clavulanic acid for a total of 14 days. Bacterial cultures of the purulent material obtained grow Streptococcus anginosus, Prevotella sp., and non-typeable Haemophilus influenzae. The anatomic space bordered by the anterior tonsillar pillar, the posterior tonsillar pillar, the palatine tonsil capsule, and the superior pharyngeal constrictor. This space communicates with the parapharyngeal space Parapharyngeal space The anatomic space bordered by the skull base, the hyoid bone, the cervical vertebra and vertebral muscles, the pterygo-mandibular raphe, and the parotid gland. This space communicates with the submandibular, peritonsillar, retropharyngeal, and sublingual spaces Retropharyngeal space This anatomic space lies posterior to the pharynx, bordered by the cervical fascia, carotid sheaths, skull base, and mediastinum. This space communicates with the parapharyngeal space Prevention of acute rheumatic fever, reduction in peritonsillar abscess formation 3. Pharyngitis (pediatric), odontogenic infection (adults) A clinical approach to tonsillitis, tonsillar hypertrophy, and peritonsillar and retropharyngeal abscesses Infections of the neck Lemierre's syndrome: a systematic review Clinical practice guideline for the diagnosis and management of Group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America Deep neck infection