ear, nose, and throat disorders
Retropharyngeal Abscess
Introduction
Retropharyngeal abscesses, most common among young children, can cause sore throat, fever, neck stiffness, and stridor. Diagnosis requires lateral neck x-ray or CT. Treatment is with endotracheal intubation, drainage, and antibiotics. Retropharyngeal abscesses develop in the retropharyngeal lymph nodes at the back of the pharynx, adjacent to the vertebrae. They can be seeded by infection of the pharynx, sinuses, adenoids, or nose. They occur mainly in children 1 to 8 years because the retropharyngeal lymph nodes begin to recede by 4 to 5 years. However, adults may develop infection after foreign body ingestion or after instrumentation. Common organisms include aerobic (StreptococcusandStaphylococcusspecies) and anaerobic (BacteroidesandFusobacterium) bacteria and, increasingly in adults and children, HIV and tuberculosis. The most serious consequences include airway obstruction, septic shock, rupture of the abscess into the airway resulting in aspiration pneumonia or asphyxia, mediastinitis, carotid rupture, and suppurative thrombophlebitis of the internal jugular veins (Lemierre syndrome). 