An infection in the deep neck space causes a retropharyngeal abscess. The condition can cause fatal airway obstruction, so doctors treat it as a medical emergency.
A person’s symptoms can include spiking fever, difficulty swallowing, or their head twisted at an angle. Treatment may involve surgery or intravenous antibiotics.
This article discusses a retropharyngeal abscess in more detail, including its causes, symptoms, and complications, alongside how doctors diagnose and treat the condition. Finally, it answers some common questions about retropharyngeal abscesses.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
The retropharyngeal space (RPS) is a
Sometimes doctors refer to retropharyngeal abscesses as deep neck space abscesses.
Studies indicate that cases of retropharyngeal abscesses increased between 2003–2012 in the United States, and male children predominantly experienced the infections.
Symptoms of a retropharyngeal abscess may include those present in other conditions, such as a sore throat or fever. Some
- spiking fever
- difficulty or pain when swallowing
- neck pain
- head twisted at an angle which doctors refer to as torticollis
- a reduction in drinking
- loss of appetite
- chest pain
- difficulty breathing
- trismus, also known as lockjaw
- change in voice
Infection involving lymphatic drainage in the neck, middle ear, or sinuses
A prior upper respiratory tract infection is present in
Bacteria, such as Streptococcus pyogenes and Staphylococcus aureus, commonly cause retropharyngeal infections.
Additionally, experts advise that risk factors for RPS infection include:
- poor oral hygiene
- a compromised immune system
- low socioeconomic status
Symptoms of a retropharyngeal abscess may be nonspecific, for example, a sore throat or fever. Therefore, doctors need to perform further tests to diagnose the condition.
A doctor may recommend blood tests if they do not cause additional distress and affect the airways, which may occur in younger children. Someone may also need an X-ray or CT scan of the neck or chest. In addition, doctors may use ultrasound for children as it does not involve radiation.
Healthcare professionals often make a differential diagnosis. Some other conditions with similar symptoms include pneumonia, a foreign body in the airways, or pharyngitis.
If a retropharyngeal abscess obstructs the airways, it
Other complications of a retropharyngeal abscess include:
- bronchial erosion, which affects bronchi or air passages in the lungs
- acute respiratory distress syndrome
- erosion into the carotid artery or jugular vein
- meningoencephalitis, which involves inflammation of the meninges and the brain
- cranial nerve palsies, which is when one or more cranial nerves do not function
- esophageal perforation, which is when a hole develops in the esophagus
- mediastinitis, which is inflammation of tissues in the middle part of the chest
Additionally, people who need surgery may require rehabilitation or therapy to regain joint movement, muscle strength, and speech.
Anyone with a confirmed diagnosis of retropharyngeal infection
As a retropharyngeal abscess grows, it can obstruct the airway and cause breathing difficulties or suffocation. In these cases, a doctor performs an immediate surgical incision and drains the abscess. Guidelines state that abscesses greater than 2 centimeters with symptoms for 2 days or more warrant surgical intervention.
After a person clinically improves and their fever subsides, doctors may replace intravenous antibiotics with oral antibiotics for 14 days. After that, the doctor may discharge the individual with strict instructions to monitor their condition at home.
A person should call 911 or visit their nearest emergency room if they are experiencing symptoms of a retropharyngeal abscess.
Below are some common questions and answers about retropharyngeal abscesses.
Is a retropharyngeal abscess an emergency?
Without treatment, a retropharyngeal abscess
Are retropharyngeal abscesses common?
What can prevent a retropharyngeal abscess?
People should consult a doctor as early as possible if they have any upper respiratory symptoms or fever to prevent infection from worsening or leading to a retropharyngeal abscess. In addition,
Retropharyngeal abscesses are uncommon childhood conditions that can potentially cause death. The condition can also occur less frequently in adults.
People with symptoms of a retropharyngeal abscess, such as fever, difficulty swallowing, or their heads twisted at an angle, should seek medical attention immediately. Retropharyngeal abscesses sometimes result from a respiratory tract infection, tonsilitis, or dental infection.
A retropharyngeal abscess may obstruct a person’s airways and cause suffocation, so doctors treat the condition as a medical emergency. Doctors usually admit people to intensive care and may treat them with antibiotics or surgery.