Retropharyngeal abscess

Retropharyngeal abscess

Definition:

A collection of pus in the tissues in the back of the throat. See also Peritonsillar abscess.

Causes, incidence, and risk factors:

Retropharyngeal abscess is a disease of children generally under age 5 years. Tissues at the back of the throat in young children allow for the formation of a pus-filled space (which doesn't occur in adults) immediately behind the back of the throat. This area can become secondarily infected during or immediately following a bacterial sore throat.

The affected child, who may still have symptoms of the original sore throat, develops a high fever with an extremely severe sore throat. The pain causes difficulty swallowing and the expanding abscess may interfere with breathing. Complications can be life-threatening.

Retropharyngeal abscess requires immediate attention to prevent severe complications.

Symptoms:

prior or present sore throat, infected nose, tooth abscesses
high fever
severe throat pain
difficulty swallowing
drooling
breathing difficulty
intercostal retractions (the muscles between the ribs pull in when breathing)
stridor (a high-pitched sound when inhaling)

Signs and tests:

X-ray, lateral neck or CT scan of the neck (demonstrates pus filled space between throat and neck vertebrae)
CBC (elevated white blood count)
throat culture (may demonstrate organism, Group A strep, Staph, and so on)

Treatment:

Surgical drainage of the abscess and high-dosage intravenous antibiotics are used to treat the infection. Protection of the airway from becoming completely blocked by the retropharyngeal swelling.

Expectations (prognosis):

Full recovery without sequela is expected following prompt treatment.

Complications:

Calling your health care provider:

Call your health care provider if you develop a high fever with severe throat pain. Breathing difficulty, intercostal retractions, and stridor indicate that an emergency situation is developing!

Prevention:

Prompt diagnosis and treatment of pharyngitis or nasopharyngeal infections will generally prevent the development of retropharyngeal abscess.

Review Date: 11/9/2001
Reviewed By: Ashutosh Kacker, M.D., Department of Otolaryngology, New York Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network.

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