Article Sections

Introduction

Retropharyngeal abscess (RPA) is a serious bacterial infection characterized by pus in the retropharyngeal space.  Abscess formation may be preceded by an upper respiratory infection or traumatic injury that introduces bacteria into the space.  Typical symptoms include fever, odynophagia, and neck stiffness.  Expansion of an abscess in this area can cause airway compression, and lead to respiratory failure and death.  Treatment includes broad-spectrum antibiotics and possibly surgical incision and drainage.

Anatomy

The retropharyngeal space is a fascial space that extends from the skull base to the mediastinum ( Figure 1).  It is bordered anteriorly by the pharynx and esophagus and posteriorly by the vertebral bodies.  In young children, this space contains lymph nodes that drain structures such as the tonsils, adenoids, sinuses and middle ear.  However, these lymph chains atrophy with age and typically regress before puberty.

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