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, incidence, and risk factors
Retropharyngeal abscess generally affects children under age 5, but it can occur at any age.
Infected material (pus) builds up in the space around the tissues at the back of the throat. This can occur during or immediately after a throat infection.
Symptoms
- Breathing difficulty
- Difficulty swallowing
- Drooling
- High fever
- High-pitched sound when inhaling (stridor)
- Muscles between the ribs pull in when breathing (intercostal retractions)
- Severe throat pain
Signs and tests
The health care provider will perform a physical exam 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.
Other tests may include:
- Complete blood count (CBC)
- CT scan of the neck
- X-ray of the neck
Treatment
Surgery is needed to drain the infected area. Corticosteroids are sometimes given to reduce airway swelling. High-dose antibiotics are given through a vein (intravenous) to treat the infection.
The airway will be protected so that it does not become completely blocked by the swelling.
Expectations (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, you can make a full recovery.
Complications
- Airway obstruction
- Aspiration
- Mediastinitis
- Osteomyelitis
This list may not include all types of complications.
Calling your health care provider
Call your health care provider if you or your child develops a high fever with severe throat pain.
Seek immediate medical help if you have:
- Breathing difficulty
- High-pitched breathing sounds (stridor)
- Muscles between the ribs pull in when breathing (intercostal retractions)
Prevention
Prompt diagnosis and treatment of pharyngitis or upper respiratory infections will generally prevent retropharyngeal abscess.
References
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.
Review Date:10/10/2008
Reviewed By:Alan Lipkin, MD, Otolaryngologist, Private Practice, Denver, Colorado. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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