A retropharyngeal abscess (RPA) is an infection that develops in the deep spaces of the neck, more common in children under five due to their prominent lymph nodes. However, it can also occur in adults. To our knowledge, Case reports of RPA revealing Granulomatosis with polyangiitis (GPA) (Wegener’s) have yet not been reported. We present a case of a 62-year-old woman, originally from West Africa, with symptoms of sore throat, shortness of breath and otalgia. Imaging was compatible with RPA. Surgical drainage involved endoscopic and oral procedures with biopsies. Culture showed Streptococcus gallolyticus, blood tests revealed positive anti-nuclear antibodies (ANA) and anti-neutrophil cytoplasmic antibodies (C-ANCA) and pathological exam indicated vasculitis lesions. Treatment included broad-spectrum antibiotics, steroids and immunosuppressants. RPA occurs in the space between the buccopharyngeal and alar fascia from the skull base to the posterior mediastinum. Patients with RPA present symptoms including: fever, neck pain, swelling nuchal rigidity, sore throat, cervical lymphadenopathy, respiratory distress or stridor. In some cases, RPA can reveal an underlying disease like GPA, which is a necrotizing vasculitis often revealed by ENT symptoms. Nevertheless, ENT involvement in GPA is associated with better prognosis but more relapses.
Hajjij et al. (Thu,) studied this question.