Paediatric infections: retropharyngeal abscess: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Paediatric infections: retropharyngeal abscess

Sample item

An 18-month-old has fever, drooling, refusal to feed, a stiff neck that resists extension and a muffled voice. Which finding is expected on a lateral neck radiograph?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Widened prevertebral soft tissue shadow

Retropharyngeal abscess follows suppuration of retropharyngeal lymph nodes in young children and causes neck stiffness, drooling and respiratory difficulty. A lateral neck film shows thickened prevertebral soft tissue, sometimes with gas, and contrast CT confirms and defines the collection. Treatment is antibiotics with drainage for large abscesses.

Option by option

  • A. Steeple sign in the subglottis

    The steeple sign is seen in croup on frontal neck films.

  • B. Bilateral hilar lymphadenopathy

    Hilar lymphadenopathy suggests tuberculosis or sarcoid and is unrelated.

  • C. Thumb sign at the epiglottis

    The thumb sign is seen in epiglottitis.

  • D. Widened prevertebral soft tissue shadow (correct)

    Correct. Prevertebral soft tissue widening is the radiographic clue.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Widened prevertebral soft tissue shadow. Retropharyngeal abscess follows suppuration of retropharyngeal lymph nodes in young children and causes neck stiffness, drooling and respiratory difficulty.

Why is "Steeple sign in the subglottis" not the answer?

The steeple sign is seen in croup on frontal neck films.

Why is "Bilateral hilar lymphadenopathy" not the answer?

Hilar lymphadenopathy suggests tuberculosis or sarcoid and is unrelated.

Why is "Thumb sign at the epiglottis" not the answer?

The thumb sign is seen in epiglottitis.

What concept does this question test?

It tests Paediatric infections: retropharyngeal abscess in Pediatrics. A lateral neck film shows thickened prevertebral soft tissue, sometimes with gas, and contrast CT confirms and defines the collection. Treatment is antibiotics with drainage for large abscesses.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric infections: retropharyngeal abscess?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.