RPA

EM@3AM: Retropharyngeal Abscess

A 3-year-old male is brought in by his mother for severe throat pain and lethargy. She notes that he is playing less, refusing to eat, and preferring to lie supine. Review of systems is remarkable for a recent small fall with his toothbrush in his mouth. Triage vital signs include BP 91/49, HR 141, T 103.1 temporal, RR 25, SpO2 96% on room air. He appears toxic and is lying supine. The oropharyngeal exam is normal, but the patient has prominent generalized cervical lymphadenopathy, torticollis, and a painful tracheal rock. The patient has no voice changes but does not want to extend his neck. What’s the most likely diagnosis?

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Strep Throat Mimics: Pearls & Pitfalls

Pharyngitis accounts for a large number of Emergency Department and Urgent Care visits each year. The majority of cases are due to a viral etiology, and Group A Beta-hemolytic streptococcus accounts for 15% to 30% of cases. However, a wide array of diseases may present similarly, with several of these potentially life-threatening. This post looks at these mimics and more.

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