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Retropharyngeal Abscess

Deep neck space infection requiring urgent recognition and drainage

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our KBB (Kulak Burun Boğaz) department. Book Appointment →

What is Retropharyngeal Abscess?

Retropharyngeal abscess is a suppurative infection of the deep neck space between the posterior pharyngeal wall and the prevertebral fascia. It most commonly affects children under 6 years through suppuration of retropharyngeal lymph nodes, while in adults it usually follows penetrating trauma, foreign body ingestion or extension from contiguous infection.

The polymicrobial flora typically includes Streptococcus pyogenes, Staphylococcus aureus, oral anaerobes and Haemophilus species. Untreated abscesses may cause airway compromise, jugular vein thrombosis (Lemierre syndrome), descending mediastinitis, septic shock and carotid artery erosion. CT with contrast is the diagnostic gold standard.

Symptoms

High fever and chills
Severe sore throat and odynophagia
Neck stiffness and torticollis
Drooling and refusal to feed (children)
Muffled or hot-potato voice
Stridor and respiratory distress
Trismus and neck swelling
Bulging posterior pharyngeal wall on examination

Risk Factors

Recent upper respiratory tract infection
Tonsillitis or pharyngitis
Pharyngeal trauma or foreign body
Dental or sinus infection
Diabetes mellitus
Immunocompromised state
Recent endotracheal intubation or endoscopy
Children under 6 years old

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Stridor or breathing difficulty (emergency)
  • Severe neck pain with limited movement
  • High fever with sore throat unresponsive to antibiotics
  • Drooling or inability to swallow
  • Bulging in the back of the throat
  • Voice changes with neck swelling
  • Recent throat trauma followed by fever

Treatment Methods

01
Priority airway assessment with intubation or tracheostomy preparation
02
Contrast-enhanced CT of the neck for diagnosis and surgical planning
03
Empiric IV broad-spectrum antibiotics (ampicillin-sulbactam, clindamycin or piperacillin-tazobactam)
04
Vancomycin added when MRSA is a concern
05
Surgical incision and drainage via transoral or external cervical approach for organized collections
06
CT-guided percutaneous aspiration in selected stable patients with small abscesses
07
ICU admission and hemodynamic support for severe sepsis
08
Steroid administration for significant airway edema
09
Tailoring antibiotic therapy to culture and sensitivity results

Which Department to Visit?

You can visit our KBB (Kulak Burun Boğaz) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About KBB (Kulak Burun Boğaz) Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.