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Retropharyngeal abscess

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

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

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. This is to take a sample of tissue to check it more closely and is called a throat culture .

Other tests may include:

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. This is life-threatening. With prompt treatment, a full recovery is expected.

Complications

This list may not include all 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 right away 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 can prevent retropharyngeal abscess.

References

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

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

Melio FR. Upper respiratory tract infections. In: Marx JA, Hockberger RS, Wallis RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Elsevier Mosby; 2009:chap 73.

Updated: 11/9/2012

Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.


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