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Richard E. Goulding, MD
Melbourne, Fla

JAMA. 1986;256(19):2675.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

I enjoyed reading the article on retropharyngeal soft-tissue swelling,¹ but I beg to differ with the diagnosis given. My conclusion is that this appeared to be a retropharyngeal abscess or possibly a phlegmon because it resolved so readily with antibiotics.

Thyroid tenderness is difficult to differentiate from anterior neck tenderness caused by an expanding abscess in the retropharyngeal or retrotracheal space. Indeed, the anterior neck will be tender in either entity. Needle aspiration of thyroid tissue will do little to detect purulent material in the retropharyngeal space.

Poor dentition, as was noted on the original physical examination, is one of the causative factors for development of an abscess. Differentiating between subacute thyroiditis and retropharyngeal abscess is not difficult. Prompt needle aspiration of the retropharyngeal space, perhaps under radiographic, ultrasound, or computed tomographic scan control, should be done. There might be some difficulty, especially in patients with rather . . . [Full Text PDF of this Article]

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