Rapidly Progressing Retropharyngeal Abscess in a Six-Month-Old: Anesthetic and Diagnostic Challenges Leading to Lemierre’s Syndrome

Retropharyngeal abscesses (RPAs) are serious infections in children that often stem from tonsillitis and can quickly lead to life-threatening complications due to the unique anatomy of the neck. These abscesses commonly present with fever, difficulty swallowing, and respiratory distress, and can progress to conditions such as mediastinitis, empyema, and Lemierre's syndrome (LS) if left untreated. This case report follows a six-month-old infant who initially presented with persistent fever, anasarca, and a suspected deep neck space infection. The RPA rapidly worsened, resulting in empyema, LS, and a pseudoaneurysm of the internal carotid artery. The patient required multiple surgeries, including drainage of abscesses in the neck and chest, as well as treatment for thromboembolic and respiratory complications. This case underscores the importance of early diagnosis, quick intervention, and careful anesthetic management in preventing severe outcomes in children with RPAs.