Retropharyngeal Abscess

Retropharyngeal abscess is a condition in which pus collects in proximity to several lymph nodes in the potential space at the back of the throat.

Retropharyngeal abscess (RPA) is a disease seen primarily in children less than 6 years of age. RPA is especially of concern in a child who appears ill and has limited neck mobility. Among patients with RPA, 60% had an antecedent HEENT infection (URI, pharyngitis, and otitis or mastoiditis); 40% had a history of foreign body or trauma. Adults more often have a history of intraoral procedure, foreign body or trauma, or poor dentition.

Causes

1. Aerobic organisms, such as group A hemolytic Streptococci, Staphylococcus aureus
2. Oral anaerobic organisms

Symptoms

• Fever ++++
• Neck swelling +++
• Poor oral intake +++
• Sore throat +++
• Drooling
• Dysphagia
• Odynophagia

Signs

• Cervical adenopathy +++
• Posterior pharyngeal "bulge" or swelling +++
• Stridor ++
• Neck stiffness ++
• Atraumatic torticollis may occur and confers an increased risk of atlantoaxial subluxation.

Treatment

Surgical drainage of the abscess and high-dose intravenous antibiotics are used to treat the infection. The airway needs to be protected from becoming completely blocked by the swelling.