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Retropharyngeal abscess

 

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

Retropharyngeal abscess most often 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 very soon after a throat infection.

Symptoms

 

Symptoms include:

  • 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
  • Difficulty turning the head

 

Exams and Tests

 

The health care provider will perform a physical exam and look inside the throat. The provider may gently rub the back of the throat with a cotton swab. This is to take a sample of tissue to check it more closely. It 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.

 

Outlook (Prognosis)

 

It is important to get medical help right away. This condition can lead to blockage of the airway. This is life-threatening. With prompt treatment, a full recovery is expected.

 

Possible Complications

 

Complications may include:

  • Airway obstruction
  • Aspiration
  • Mediastinitis
  • Osteomyelitis

 

When to Contact a Medical Professional

 

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

Get medical help right away if you have:

  • Breathing trouble
  • High-pitched breathing sounds (stridor)
  • Retraction of the muscles between the ribs when breathing

 

Prevention

 

Prompt diagnosis and treatment of a sore throat or upper respiratory infection can prevent this problem.

 

 

References

Duncan NO. Infections of the airway in children. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Elsevier Mosby; 2010:chap 197.

Melio FR, Berge LR. Upper respiratory tract infections. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 75.

Shirley WP, Woolley AL, Wiatrak BJ. Pharyngitis and adenotonsillar disease. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Elsevier Mosby; 2010:chap. 196.

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      Oropharynx

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      Tests for Retropharyngeal abscess

       
         

        Review Date: 11/25/2014

        Reviewed By: Ashutosh Kacker, MD, BS, Professor of Clinical Otolaryngology, Weill Cornell Medical College, and Attending Otolaryngologist, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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