Retropharyngeal abscess

Revision as of 12:40, 21 November 2011 by Jswartz (talk | contribs)

Background

  • Polymicrobial abscess in space between posterior pharyngeal wall and prevertebral fascia
  • Adults: Due to direct extension of purulent debris from adjacent site (e.g. Ludwig angina)
    • More likely to extend into the mediastinum
  • Children: Due to suppurative changes within a lymph node (primary infection elsewhere in head or neck)

Clinical Features

  • Sore throat (76%)
  • Fever (65%)
  • Torticollis (37%)
  • Dysphagia (35%)
  • Late symptoms:
    • Stridor, respiratory distres, chest pain (mediastinitis)

Diagnosis

  • CT neck w/ IV contrast
    • Gold standard

Treatment

  • Emergent ENT consult
    • Most patients require I&D
  • Secure airway
  • Abx
    • Clindamycin 600-900mg IV OR
    • Cefoxitin 2gm IV

Disposition

  • Admit

Source

Tintinalli

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