The correct answer is "3. Surgical consultation for incision and drainage under general anesthesia"
Suppurative infection of the chain of lymph nodes between the posterior pharyngeal wall and the prevertebral fascia leads to retropharyngeal abscesses. The most common causative organisms are Staphylococcus aureus, group A ß-hemolytic streptococci, and oral anaerobes. Presenting signs and symptoms include a history of pharyngitis, abrupt onset of fever with severe sore throat, refusal of food, drooling, and muffled or noisy breathing. A bulge in the posterior pharyngeal wall is diagnostic, as are radiographs of the lateral neck that reveal the retropharyngeal mass. Palpation (with adequate provision for emergency control of the airway in case of rupture) reveals a fluctuant mass. Treatment should include incision and drainage if fluctuance is present.