The Key to Early Diagnosis: Retropharyngeal Abscess Masked by Neck Extension Limitation in a Pediatric Patient.

Retropharyngeal abscess (RFA) is a rare but potentially life-threatening deep neck infection in children and may lead to airway obstruction, mediastinitis, vascular complications, and other severe outcomes. In the pediatric population, RFA typically develops as a result of lymph node suppuration in this region secondary to an upper respiratory tract infection. We present the case of an 8-year-old boy who presented to the pediatric emergency department with sore throat, dysphagia, and nasal congestion. Because restricted neck extension raised suspicion for a deep neck infection, the patient was referred for otolaryngologic evaluation. The diagnosis of RFA was established based on characteristic findings on computed tomography, supported by the laboratory results. The patient was admitted to the hospital for treatment and was discharged after receiving parenteral antibiotic therapy. This case highlights the importance of careful head and neck examination, prompt recognition of restricted neck movement, and timely imaging in children with subtle upper respiratory tract symptoms.