A retropharyngeal abscess is a life-threatening collection of pus that forms in the back of the throat. It typically develops when the lymph nodes behind your throat become infected. They may have several causes, but a retropharyngeal abscess requires immediate medical attention.
Is a Retropharyngeal Abscess Rare?
A retropharyngeal abscess is rare. The specific lymph nodes in which they grow start to disappear on their own by age 5. Usually, any abscesses occur in children ages 1 to 8. They are uncommon in adults.
A retropharyngeal abscess appears in the retropharyngeal space, where the series of lymph nodes drain into the nasal cavity, back of the nose and throat, sinuses, and ears.
What Is an Abscess?
Abscesses are usually the result of bacterial infections. They form when your immune system sends white blood cells to fight off infections. When these cells attack the infections, nearby tissue dies and creates a hole. This hole fills with a pus mixture of dead tissue, white blood cells, and bacteria.
Abscesses can form from localized infections or can come from an infection in a different part of your body.
What Causes a Retropharyngeal Abscess?
Retropharyngeal abscesses causes include:
- Upper respiratory tract infections. This infection occurs in your sinuses and throat. Symptoms are typically stuffy noses, sore throats, and coughs. On its own, an abscess is not necessarily dangerous, but in severe cases, it can be. A respiratory infection is responsible for half of all retropharyngeal abscesses.
- Ear infections. Children are more likely to get ear infections. Due to the eardrum’s proximity to the retropharyngeal abscess, the infection can easily create a retropharyngeal abscess.
- Throat infections. Viruses or bacteria typically cause throat infections like tonsillitis, which can lead to retropharyngeal abscesses.
- Injury to the throat region. Injuries to this region can cause trauma and holes in the retropharyngeal area, which leads to retropharyngeal abscesses.
What Are the Symptoms of a Retropharyngeal Abscess?
The most common retropharyngeal abscess symptoms are:
- Difficulty swallowing
- Pain when swallowing
- Fever
- Swelling in the lymph nodes
- Stiff neck
- Challenges breathing
- Noisy inhalation
- Neck pain
In children, common retropharyngeal abscess symptoms include:
- Drooling
- Not wanting to eat or drink
- Refusing to move due to pain
- Swollen necks or lymph nodes
- Tightly closed mouths
- Hoarse or altered voice
- Difficulty breathing
- Noisy breath
- Chest pain
Children might lay on their back and tilt their neck back by raising their chin to make breathing easier.
How is a Retropharyngeal Abscess Diagnosed?
Blood tests can help diagnose a retropharyngeal abscess. However, if drawing blood is too distressing for a child, it should be delayed.
Typically, a lateral (sideways) X-ray of the neck will be used to diagnose a retropharyngeal abscess. The radiation exposure is low with this type of imaging.
What Is the Treatment for a Retropharyngeal Abscess?
If you have a severe case of a retropharyngeal abscess, you will need to go to the hospital and immediately receive intravenous antibiotics. If your airways are closing or are severely affected, you may need to get emergency airway surgery.
For less severe cases, you will still need to be admitted to the hospital and receive intravenous antibiotic therapy, typically for a few days. If you still have symptoms, you may need surgery to drain the abscess.
Following your surgery, you will be very closely monitored to make sure there are no issues with your breathing. After you are discharged, you will need to continue taking antibiotics until there is no sign of infection.
It is important to note that while retropharyngeal abscesses are rare, there is a relatively high mortality rate associated with them. Therefore, you or anyone else who has one should get immediate and adequate treatment.