Retropharyngeal abscess on patient with diabetes mellitus type-2, dental cavity, and oral candidiasis
DOI:
https://doi.org/10.32637/orli.v54i2.668Abstract
Background: Retropharyngeal abscesses are uncommon but potentially life-threatening diagnosis. Treatment of retropharyngeal abscess ranges from prolonged courses of intravenous antibiotics to surgical incision and drainage. Purpose: To disclose a case of retropharyngeal abscess, and to study the management. Case report: A 64-year-old male came to the emergency room complaining of pain when swallowing for one week. The pain became more severe and unabling him to eat solid food. Patient also had diabetes mellitus, dental cavity and oral candidiasis. Clinical question: In patients with retropharyngeal abscess, when does incision and drainage need to be performed? How is the recovery rate compared to conservative treatment? Review method: The literatures were searched on PubMed, Medline database as well and Google Scholar. The literatures obtained were then filtered according to the publications in the last 10 years. Result: Literature and studies of retropharyngeal abscess that were found commonly studies in children, but there were also studies in adults, more likely in a wider scope as deep cervical abscess. Conclusion: Incision and drainage are the therapy of choice for adult patient, while conservative antibiotic therapy, was the first option for pediatric retropharyngeal abscess.
Keywords: retropharyngeal abscess, deep cervical abscess, incision and drainage, conservative therapy
ABSTRAK
Latar belakang: Abses retrofaring merupakan diagnosis yang jarang ditemui namun dapat menyebabkan kondisi yang mengancam jiwa. Penatalaksanaan pada abses retrofaring dapat bervariasi, dengan pemberian terapi antibiotik intravena hingga insisi drainase. Tujuan: Untuk melaporkan satu kasus abses retrofaring, dan mempelajari penatalaksanaan terapinya. Laporan kasus: Seorang laki-laki 64 tahun datang ke instalasi gawat darurat dengan keluhan nyeri saat menelan, selama satu minggu. Nyeri bertambah berat, dan tidak bisa menelan makanan padat. Pasien memiliki riwayat diabetes mellitus, karies gigi, dan candidiasis. Pertanyaan klinis: Bagaimana panduan terapi pada kasus abses retrofaring, serta kapan insisi drainase perlu dilakukan? Bagaimana angka kesembuhan dibandingkan terapi konservatif? Telaah literatur: Literatur diperoleh dari PubMed, Medline dan Google Scholar, kemudian literatur disaring menurut publikasi 10 tahun terakhir. Hasil: Literatur dan penelitian mengenai abses retrofaring yang ditemukan umumnya diteliti pada populasi anak-anak, namun ada juga penelitian pada orang dewasa yang didapatkan dalam lingkup yang lebih luas sebagai kasus abses leher dalam. Kesimpulan: Insisi dan drainase pada pasien dewasa merupakan pilihan utama terapi dalam lingkup yang lebih luas yaitu abses leher dalam, sedangkan terapi antibiotik konservatif pada abses retrofaring anak masih menjadi pilihan utama.
Kata kunci: abses retrofaring, abses leher dalam, insisi drainase, terapi konservatif
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