Retropharyngeal abscess

Definition

Retropharyngeal abscess is a collection of pus in the tissues in the back of the throat. It is a potentially life-threatening medical condition.

See also: Peritonsillar abscess

Causes

Retropharyngeal abscess generally affects children under age 5. Infected material (pus) builds up in the space around the tissues at the back of the throat. This can occur during or immediately following a throat infection.

Symptoms

• Recent sore throat or infected nose or teeth
• 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)

Exams and Tests

The health care provider will perform a physical examine and look inside the throat. The doctor or nurse may gently rub the back of the throat with a cotton swab, so that a sample of tissue can be more closely examined. This is called a throat culture.

A complete blood count may be done to check for signs of infection. An x-ray or CT scan of the neck may show pus in the space between throat and neck.

Treatment

Surgery is needed to drain the infected area. High-dose intravenous antibiotics are used to treat the infection.

The airway will be protected so that it does not become completely blocked by the swelling.

Outlook (Prognosis)

It is important to get immediate medical help. This condition can lead to blockage of the airway, which can be life threatening. With prompt treatment, a patient can make a full recovery.

Possible Complications

• Aspiration
• Airway obstruction
• Osteomyelitis
• Mediastinitis

This list may not include all types of complications.

When to Contact a Medical Professional

Call your health care provider if you or your child develop a high fever with severe throat pain.

Seek immediate medical help if there breathing difficulty, intercostal retractions, and stridor.

Prevention

Prompt diagnosis and treatment of pharyngitis

Cummings CW, Flint PW, Haughey BH, et al. Otolaryngology: Head & Neck Surgery. 4th ed. St Louis, Mo; Mosby; 2005:4365-4367.

Marx J. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo: Mosby; 2006:1120-1121.