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An emergency Contrast Enhancement CT (CECT) scan demonstrated right retropharyngeal subtle hypodensity with mass effect and faint intermittent peripheral rim enhancement suggestive of early organizing retropharyngeal abscess. The CT value of the central hypodensity measured 34 House field units (Figure 1a). In addition there was edematous change of the retropharyngeal space (RPS), Right Parapharyngeal Space (PPS) and Right Carotid Space (CS). Multiple reactive enhancing lymph nodes were seen along the right side of the neck. The right jugular vein was attenuated. Non-occlusive thrombus was seen in the right transverse and sigmoid sinus extending into the right upper jugular vein.