A retropharyngeal abscess is inferred when the prevertebral soft tissue shadow is more than 2/3 rd the thickness of the body of the corresponding vertebrae.
RRPA develops secondary to lymphatic drainage or contiguous spread of upper respiratory or oral infections. Pharyngeal trauma from endotracheal intubation, endoscopy, foreign body ingestion, and removal may cause a subsequent RPA. Patients who are immunocompromised or chronically ill, such as persons with diabetes, cancer, alcoholism, or AIDS, are at increased risk for RPA.
The most common organisms causing retropharyngeal abscesses include aerobes and anaerobes; gram-negative organisms also may be observed. Often, mixed flora are cultured.
Retropharyngeal abscess generally affects children under age 5. Tissues at the back of the throat in young children allow a pus-filled space to form immediately behind the back of the throat. This area can become secondarily infected during or immediately following a bacterial sore throat.
The affected child, who may still have symptoms of the original sore throat, develops a high fever with an extremely severe sore throat. The pain causes difficulty swallowing and the expanding abscess may interfere with breathing. Complications can be life-threatening.
Retropharyngeal abscess requires immediate attention to prevent severe complications. Surgical drainage of the abscess and high-dose intravenous antibiotics are used to treat the infection. The airway needs to be protected from becoming completely blocked by the swelling.
Complications:
- Atlantooccipital dislocation
- Adult respiratory distress syndrome (ARDS)
- Erosion of the second and third cervical vertebrae
- Cranial nerve deficits (cranial nerves IX-XII are contained in the cervical fascia)
- Septic thrombosis of jugular vein or hemorrhage secondary to erosion into carotid artery.
