A retropharyngeal abscess is a potentially serious complication of a throat infection. Abscesses are essentially masses of pus and diseased tissue that develop in the back of the throat following a bacterial or viral infection. The condition can becomes deadly if an abscess grows large enough to block the airway. Retropharyngeal abscesses are becoming rare due to modern advances in antibiotic care, but young children and people with weak immune systems are at risk if they do not receive proper treatment for throat infections.
Many different pathogens can result in retropharyngeal abscesses, but most cases are caused by strains of streptococci and staphylococci. Children who experience frequent respiratory tract infections are at the highest risk of developing abscesses due to chronic throat irritation that never fully goes away. Elderly people and adults with AIDS, cancer, and other conditions that weaken their immune systems are also at an increased risk of throat complications.
The symptoms of a retropharyngeal abscess may include a sore throat, pain in the jaws and neck, wheezing, and difficulty swallowing. As an abscess grows, breathing becomes shallow and swallowing food and liquids can become very painful. Nausea, fever, and chills are common as an infection worsens. Left untreated, pus drainage in the throat can lead to painful coughing, stomach pain, and eventual airway obstruction. A child or adult who experiences breathing difficulties and severe throat pain should be brought to an emergency room as soon as possible.
A doctor can diagnose a retropharyngeal abscess by inspecting the mouth and throat, asking about symptoms, and testing a blood sample for increased white blood cell counts. Neck x-rays and computerized tomography scans may be performed to determine the severity of airway constriction and look for tissue damage further down the throat. After identifying a retropharyngeal abscess, a doctor usually collects a throat culture to test for specific bacteria or viruses.
Treatment for a retropharyngeal abscess depends on the severity of symptoms. Patients who have severe breathing difficulties are immediately admitted into the hospital to receive intravenous medications and oxygen therapy. A breathing tube may need to be inserted if airway obstruction becomes life-threatening. Surgery is needed in most cases to aspirate the abscess and excise damaged tissue. Following hospital care, a patient is usually prescribed a course of antibiotics to prevent a recurring infection during the healing phase. With prompt treatment, most people experience full recoveries from their symptoms within two months.