This protocol addresses children over 12 months and under 7 years presenting with retropharyngeal, parapharyngeal, or pharyngeal abscess in the setting of an ill appearance, concern for airway compromise, and unstable vital signs — a high-acuity scenario requiring immediate coordinated inpatient care.
Specific clinical scenario: Age >12 months and <7 years — retropharyngeal, parapharyngeal, or pharyngeal abscess — ill-appearing — concern for airway compromise — unstable vital signs — no penicillin allergy, not immunocompromised, no prior neck or airway surgery, not septic or in shock, no head/neck/airway trauma.
This age group (>12 months, <7 years) is particularly susceptible to deep neck space infections presenting with acute severity. When an ill appearance is combined with airway concern and vital sign instability, the risk profile demands PICU-level monitoring and prompt, coordinated management. This protocol is designed for that presentation in an otherwise healthy, non-immunocompromised child without prior neck surgery or current septic shock.
Management involves PICU admission with IV antibiotic therapy, airway monitoring, and supportive measures. ENT is involved early. The approach includes a defined transition from parenteral to oral antibiotics once clinical improvement is established. The complete regimen — including specific agents, dosing, and decision points — is available in the full structured protocol.
DOI: 10.3390/children9050618