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Retropharyngeal abscess
Retropharyngeal abscess is a collection of pus in the tissues in the back of the throat. It can be a life-threatening medical condition.
Causes
Retropharyngeal abscess most often 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 very soon after a throat infection.
Symptoms
Symptoms include:
-
Breathing difficulty
Breathing difficulty
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
ImageRead Article Now Book Mark Article - Difficulty swallowing
- Drooling
- High fever
-
High-pitched sound when inhaling (
stridor
)
Stridor
Stridor is an abnormal, high-pitched, musical breathing sound. It is caused by a blockage in the throat or voice box (larynx). It is most often hea...
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Muscles between the ribs pull in when breathing (
intercostal retractions
)
Intercostal retractions
Intercostal retractions occur when the muscles between the ribs pull inward. The movement is most often a sign that the person has a breathing probl...
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- Difficulty turning the head
Exams and Tests
The health care provider will perform a physical exam and look inside the throat. The provider 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. It is called a throat culture .
Throat culture
A throat swab culture is a laboratory test that is done to identify germs that may cause infection in the throat. It is most often used to diagnose ...
Other tests may include:
-
Complete blood count
(CBC)
Complete blood count
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
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CT scan
of the neck
CT scan
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
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X-ray
of the neck
X-ray
X-rays are a type of electromagnetic radiation, just like visible light. An x-ray machine sends individual x-ray particles through the body. The im...
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Fiber optic endoscopy
Fiber optic endoscopy
Endoscopy is a way of looking inside the body using a flexible tube that has a small camera and light on the end of it. This instrument is called an...
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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.
Intravenous
Intravenous means "within a vein. " Most often it refers to giving medicines or fluids through a needle or tube inserted into a vein. This allows th...
The airway will be protected so that it does not become completely blocked by the swelling.
Outlook (Prognosis)
It is important to get medical help right away. This condition can lead to blockage of the airway. This is life threatening. With prompt treatment, a full recovery is expected.
Possible Complications
Complications may include:
-
Airway obstruction
Airway obstruction
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
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Aspiration
Aspiration
Aspiration means to draw in or out using a sucking motion. It has two meanings:Breathing in a foreign object (sucking food into the airway). A medic...
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Mediastinitis
Mediastinitis
Mediastinitis is swelling and irritation (inflammation) of the chest area between the lungs (mediastinum). This area contains the heart, large blood...
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Osteomyelitis
Osteomyelitis
Osteomyelitis is a bone infection. It is mainly caused by bacteria or other germs.
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When to Contact a Medical Professional
Call your provider if you or your child develops a high fever with severe throat pain.
Get medical help right away if you have:
- Breathing trouble
- High-pitched breathing sounds (stridor)
- Retraction of the muscles between the ribs when breathing
- Difficulty turning the head
Prevention
Prompt diagnosis and treatment of a sore throat or upper respiratory infection can prevent this problem.
References
Melio FR, Berge LR. Upper respiratory tract infections. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 75.
Meyer A. Pediatric infectious disease. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head and Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 197.
Pappas DE, Hendley JO. Retropharyngeal abscess, lateral pharyngeal (parapharyngeal) abscess, and peritonsillar cellulitis/abscess. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 382.
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Throat anatomy - illustration
Structures of the throat include the esophagus, trachea, epiglottis and tonsils.
Throat anatomy
illustration
-
Oropharynx - illustration
Food passes from the mouth to the oropharynx (back of the throat) to the esophagus.
Oropharynx
illustration
Review Date: 8/17/2016
Reviewed By: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
