Retropharyngeal abscess is a type of deep neck space infection, which can be a life-threatening infection if not detected early.
Potential threat to airways should always be considered.
Symptoms may be non-specific (e.g., fever, dysphagia), especially in children under 2 years old.
CT scan of neck is the definitive investigation.
Treatment includes use of intravenous antibiotics and surgical or radiologically guided drainage. Type of surgical drainage depends on the size and extent of the abscess; this can be endo-oral or external.
History and exam
Key diagnostic factors
- presence of risk factors
- spiking fever
- neck pain or torticollis
- neck swelling/mass/lymphadenopathy
- oropharyngeal swelling
Other diagnostic factors
- decreased oral intake
- sleep apnoea
- tonsillar swelling
- increased respiration rate
- decreased oxygen saturations
- tracheal tug
- intercostal recession
- foreign body ingestion
- trauma to posterior pharyngeal wall
- dental caries/infection
- diabetes mellitus
- male sex
1st investigations to order
- erythrocyte sedimentation rate
- CT neck with contrast
- x-ray of neck
- ultrasonography of neck
- examination under anaesthetic (EUA)
no airway compromise
- Acute epiglottitis
- A clinical approach to tonsillitis, tonsillar hypertrophy, and peritonsillar and retropharyngeal abscesses
- Management of sore throat and indications for tonsillectomy: a national clinical guideline
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