Last reviewed:October 2019
Last updated:November  2019

Summary

Definition

History and exam

Key diagnostic factors

  • spiking fever
  • neck pain or torticollis
  • odynophagia
  • dysphagia
  • neck swelling/mass/lymphadenopathy
  • oropharyngeal swelling
  • drooling

Other diagnostic factors

  • decreased oral intake
  • anorexia
  • malaise
  • irritability
  • trismus
  • dysphonia
  • dyspnea
  • fatigue
  • sleep apnea
  • stridor
  • tonsillar swelling
  • increased respiration rate
  • decreased oxygen saturations
  • cyanosis
  • tachypnea
  • tracheal tug
  • intercostal recession

Risk factors

  • foreign body ingestion
  • trauma to posterior pharyngeal wall
  • dental caries/infection
  • diabetes mellitus
  • male sex
  • adenotonsillectomy

Diagnostic investigations

1st investigations to order

  • CBC
  • erythrocyte sedimentation rate
  • CT neck with contrast
  • x-ray of neck
  • ultrasonography of neck
  • examination under anesthetic (EUA)
  • culture
Full details

Treatment algorithm

Contributors

Carl Philpott

Consultant in ENT & Rhinology

James Paget University Hospital

Great Yarmouth

UK

Disclosures

CP is an author of a number of references cited in this topic and provides consultancy for Sanofi. 

Speciality trainee

Department of ENT

James Paget University Hospital

Norwich

UK

Disclosures

KH declares that he has no competing interests.

Dr Carl Philpott and Dr Kristian Hutson would like to gratefully acknowledge Dr Lorna Langstaff, Dr Asad Qayyum, Dr Kevin Kulendra, Dr Cameron Davies-Husband, and Dr Marcos Martinez Del Pero, previous contributors to this topic. LL, AQ, KK, CDH, and MMDP declare that they have no competing interests.

Peer reviewersVIEW ALL

Otolaryngologist

Head and Neck Surgeon

VU University Medical Center

Amsterdam

The Netherlands

Disclosures

RdB declares that he has no competing interests.

Director

Assistant Professor

Emory University

Atlanta

GA

Disclosures

MJ declares that he has no competing interests.

Assistant Professor

Tufts University

Boston

MA

Disclosures

LS declares that she has no competing interests.

Use of this content is subject to our disclaimer