Retropharyngeal abscess is a pus accumulation resulting from an infection in the lymph nodes present at the back of the throat.

• Throat pain and fever, accompanied by a stiff neck, difficulty in swallowing, and a characteristic noise while breathing, are the symptoms.
• Bacterial infections are the cause of retropharyngeal abscess.
• The typical symptoms help diagnose the condition; an x-ray and CT scan of the neck can confirm the diagnosis.
• Timely medical intervention and treatment help avoid complications.
• Treatment involves surgical draining of the abscess as well as antibiotic therapy to overcome the infection.

The bacterial infection which causes retropharyngeal abscess usually originates in the tonsils, sinuses, nose, adenoids, or the middle ear. Injury to the throat from objects swallowed, such as a fish bone or some other sharp object, can also lead to retropharyngeal abscesses. This condition mainly occurs in children because adults do not have these lymph nodes at the back of the throat, as these lymph nodes disappear as children grow.

Symptoms and Diagnosis

Retropharyngeal abscess may cause symptoms such as severe sore throat and fever, often accompanied by a stiff neck. Children may complain of pain and difficulty when swallowing, and keep their head tilted. They may start drooling; their voice may be muffled too.  If the abscess is blocking the airway, breathing can be difficult, and the child may find that keeping the head, as well as the neck, tilted backwards while lying on the back make it easier to breathe. Inhalation is often accompanied by a characteristic noise referred to as stridor.

If retropharyngeal abscess is not diagnosed and treated early, complications may develop. The abscess can bleed around the edges, or rupture into the airway, causing blockage. It may trigger laryngeal spasms which can make breathing even more difficult. Pneumonia is another dangerous complication. The infection can spread to the chest also. There is a risk of blood clots developing in the jugular veins. If the infection spreads to the blood, it can cause widespread malfunctioning of the vital organs, precipitating a condition referred to as septic shock.

When children have sore throat, fever and noisy breathing along with a stiff neck, the doctor may suspect retropharyngeal abscess, and further investigations are done. An x-ray of the neck and a CT scan can diagnose the illness accurately.

Treatment

When treatment is started early enough, retropharyngeal abscesses do not cause serious complications in children. In most cases, surgical drainage of the pus may be necessary in addition to the antibiotic therapy to eliminate the infection. Intravenous administration of the antibiotics such as ampicillin-sulbactam, clindamycin, or cefoxitin, is used to treat the condition initially, followed by oral medication.

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery

Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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