Retropharyngeal abscesses(RPA) are most commonly seen in infants and young children.It is an abscess located in the tissues in the back of the throat behind the posterior pharyngeal wall (the retropharyngeal space). Because RPA's typically occur in deep tissue, they are difficult to diagnose by physical examination alone.
RPA is usually caused by a bacterial infection originating from the nasopharynx, tonsils, sinuses, adenoids or middle ear. Any Upper Respiratory Infection (URI) can be a cause. RPA can also result from a direct infection due to penetrating injury or a foreign body.
Symptoms may include stiff neck (limited neck mobility or torticollis), some form of palpable neck pain , malaise, difficulty swallowing, fever, stridor, drooling, or enlarged cervical lymph nodes.RPA can lead to airway obstruction or sepsis - both life-threatening emergencies.Fatalities normally occur from patients not receiving treatment immediately and suffocating prior to knowing that anything serious was wrong. CT is the definitive diagnostic test.X ray of the neck 80% of the time shows swelling of the retropharyngeal space. If the retropharyngeal space is more than half of the size of the C2 vertebra, it may indicate retropharyngeal abscess.
RPA's frequently require surgical intervention. A tonsillectomy approach is typically used to access/drain the abscess, and the outcome is usually positive. In complex cases, tracheotomy may be required to prevent upper airway obstruction caused by edema in the neck.Antibiotics are also given.