Retropharyngeal abscess

Background

• Abscess in space between post pharyngeal wall and prevertebral fascia
  • Due to suppuration of retropharyngeal lymph nodes (regress by age 4yr)
    • Due to seeding from distant site or direct trauma (fall w/ object in mouth)

Diagnosis

• URI followed by neck pain, dysphagia, drooling, neck swelling
  • Late symptoms include stridor, respiratory distres, chest pain (mediastinitis)

Work-Up

• Lateral neck xray
  • Retropharyngeal space at C2 is 2x diameter of vertebral body
• CT w/ IV contrast
  • 100% Sn

Treatment

• Secure airway
• Abx
  • Ampicillin/sulbactam or clindamycin
• ENT consult

Disposition

Admit

Source

Tintinalli