RETROPHARYNGEAL ABSCESS

A retropharyngeal abscess is a collection of pus in the back of the throat.

• A retropharyngeal abscess is caused by a bacterial infection.
• Symptoms include difficulty and pain when swallowing, a fever, stiff neck, and noisy breathing.
• The diagnosis is based on symptoms and x-rays or computed tomography of the neck.
• Children who receive prompt treatment do well.
• The abscess is drained surgically, and antibiotics are given to eliminate the infection.

A retropharyngeal abscess forms when lymph nodes in the back of the throat become infected, break down, and form pus. Because these nodes begin to disappear by age 4 to 5 years, retropharyngeal abscesses occur mainly in children age 1 to 8 years and are uncommon in adults.

A retropharyngeal abscess is usually caused by a bacterial infection that has spread from the tonsils, throat, sinuses, adenoids, or nose. Many infections are caused by a combination of bacteria. HIV infection and tuberculosis are becoming more common causes in adults and children. An injury to the back of the throat caused by a sharp object, such as a fish bone, occasionally causes a retropharyngeal abscess.

The main symptoms of a retropharyngeal abscess are difficulty and pain when swallowing, fever, and enlargement of the lymph nodes in the neck. The voice is muffled, and children may drool. The neck may be stiff, and children may hold their head at an angle child with fever, respiratory symptoms, and neck hyperextension. Dysphagia, drooling, dyspnea, and gurgling respirations may also be present.

This occurs most commonly during the first 2 years of life. After this age, the most common cause of retropharyngeal abscess is penetrating injury of the posterior pharyngeal wall.