Parapharyngeal Abscess

An abscess in the parapharyngeal space may arise from direct extension of infection from the pharynx through the pharyngeal wall, as a consequence of odontogenic infection, local trauma, and occasionally peritonsillar abscess. Diabetes is the most common systemic condition predisposing one to parapharyngeal abscess.

Patients often present with fever, sore throat and neck swelling. Erythema, odynophagia, and dysphagia often accompany such infections. Trismus is most commonly associated with anterior compartment abscesses.

Parapharyngeal space abscess. Contrast-enhanced CT shows a low attenuation fluid collection with peripheral enhancement in the left parapharyngeal space (arrow).

Contrast-enhanced CT scanning is the imaging examination of choice to diagnose parapharyngeal abscess. CT shows a single or multiloculated low-density lesion with an air and/or fluid center with occasional enhancement of the abscess wall.