Treatment of retropharyngeal abscess ranges from prolonged courses of intravenous antibiotics to surgical incision and drainage. A retropharyngeal abscess is an uncommon but potentially life-threatening diagnosis. This disease is most common in children under the age of five but also occurs in adults.
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What do you need to know about retropharyngeal abscess?
Retropharyngeal Abscess: What You Need to Know 1 A retropharyngeal abscess is a serious infection deep in the neck,... 2 This is an unusual infection that can be difficult to diagnose. 3 In children, upper respiratory infections usually occur... 4 Retropharyngeal abscess...
When is surgical intervention indicated in the treatment of retropharyngeal abscess?
There is no evidence that patients presenting with mature abscesses greater than 3 cm2 benefit from surgical intervention before 24 to 48 hours of antibiotic therapy. All patients must have careful airway monitoring when undergoing treatment of retropharyngeal abscess, especially during the first 24 to 48 hours of therapy.
How long do antibiotics for a Retropharyngeal abscess last?
Depending on the severity of the abscess, you may be on antibiotics for two or more weeks. It's important to watch for recurrence of any symptoms. If symptoms do recur, seek immediate medical care in order to reduce your risk of complications. Retropharyngeal abscess recurs in an estimated 1 to 5 percent people.
Can a child die from a Retropharyngeal abscess?
It typically occurs in children under age eight, though it can also affect older children and adults. This infection may come on quickly, and can lead to serious complications. In severe instances, a retropharyngeal abscess can lead to death.
When does retropharyngeal abscess occur?
Retropharyngeal abscess typically occurs in children between the ages of two and four years but can occur at any age.
What causes a retropharyngeal abscess?
Typically patients under the age of five have an antecedent upper respiratory tract infection leading to suppurative cervical lymphadenitis and eventually retropharyngeal abscess. In older children and adults, a retropharyngeal abscess can be caused by trauma to the posterior pharynx, which leads to inoculation of the retropharyngeal space and results in abscess formation. Primary infections of the tonsils and of the dentition can also evolve into retropharyngeal abscesses, though more commonly into peritonsillar (Quinsy) or parapharyngeal abscesses, respectively. Direct expansion from spinal discitis or osteomyelitis is a rare cause of a retropharyngeal abscess as well. As a retropharyngeal abscess grows in size, it can lead to upper airway obstruction and asphyxiation. Treatment of retropharyngeal abscess ranges from prolonged courses of intravenous antibiotics to surgical incision and drainage.[1][2][3]
What happens after suppurative adenitis?
After suppurative adenitis or trauma results in the seeding of the retropharyngeal space, cellulitis results and eventually leads to phlegmon and abscess formation in the retropharyngeal space. Retropharyngeal abscesses are often polymicrobial infections. Bacteria that commonly contribute to these infections include Group A Streptococcus pyogenes,Staphylococcus aureus, Fusobacterium, Haemophilusspecies, and other respiratory anaerobic organisms.
Where is the retropharyngeal space?
The retropharyngeal space extends craniocaudally from the base of the skull to the posterior mediastinum and is enclosed by the buccopharyngeal and alar fascia. Retropharyngeal abscess is a suppurative collection within this space. Although infections of the prevertebral and alar spaces also can occur, infections of these anatomic spaces will not be discussed here.
Why should an emergency department physician refrain from performing an oral exam?
The emergency department physician should refrain from performing an oral exam because it may lead to irritation of the upper airways and dyspnea. If the patient is toxic, both the otolaryngologist and anesthesiologist should be notified in case an emergent airway is required.
Can retropharyngeal abscess cause death?
Although mortality from sepsis does occur in these patients, the number one cause of death in patients with retropharyngeal abscess remains upper airway occlusion. [9][10]
Can a retropharyngeal abscess cause airway obstruction?
Without proper treatment, retropharyngeal abscesses can lead to upper airway obstruction and asphyxiation. This activity reviews retropharyngeal abscesses and details important treatment considerations. This activity highlights the role of the interprofessional team in evaluating and managing this condition.
What is a 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.
What are the complications of retropharyngeal abscess?
Complications of a retropharyngeal abscess include bleeding around the abscess, rupture of the abscess into the airway ( which can block the airway), and pneumonia. The voice box (larynx) may go into spasm and further interfere with breathing. Blood clots may form in the jugular veins of the neck.
How do you get rid of an abscess in your mouth?
For both children and adults, doctors insert a plastic breathing tube through the mouth into the windpipe (trachea) to keep the airway open. Doctors then cut the abscess open allowing the pus to drain out.
How is an abscess drained?
The abscess is drained surgically, and antibiotics are given to eliminate the infection.
Can a CT scan confirm a retropharyngeal abscess?
X-rays and computed tomography. A doctor suspects a retropharyngeal abs cess in children who have a severe, unexplained sore throat, a stiff neck, and noisy breathing. X-rays and computed tomography (CT) scans of the neck can confirm the diagnosis.
Can an abscess block the airway?
The abscess can block the airway, making breathing difficult and noisy, particularly when children inhale (called stridor ). Children may lie on their back, tilt their head and neck back, and raise their chin to make breathing easier. Adults may have severe neck pain but do not always have stridor. Complications of a retropharyngeal abscess include ...
What age is retropharyngeal abscess most common?
This disease is most common in children under the age of five but also occurs in adults. Typically patients under the age of five have an antecedent upper respiratory tract infection leading to suppurative cervical …. A retropharyngeal abscess is an uncommon but potentially life-threatening diagnosis. This disease is most common in children ...
What age do you get suppurative cervical lymphadenitis?
This disease is most common in children under the age of five but also occurs in adults. Typically patients under the age of five have an antecedent upper respiratory tract infection leading to suppurative cervical lymphadenitis and eventually retropharyngeal abscess.