Infect > General > Pharyngeal

Abscess, Retropharyngeal:

Clinical:

A retropharyngeal abscess usually occurs secondary to a nasopharyngeal infection and is most common in infancy (3-4y). Patients present with fever, stiff neck, cervical adenopathy, and dysphagia. The infection is usually polymicrobial (Staph, Strep). Potential complications include: rupture with aspiration, compromised airway, mediastinitis, C-spine osteomyelitis, vascular erosion, or septic venous thrombosis.

X-ray:

On airway films there is widening of the retropharyngeal/prevertebral soft tissues and smooth anterior deviation of the airway (if deviation is "L" shaped it may be due to swallowing). Soft tissue air or a foreign body can be seen. Fluoro may be useful if the child is very irritable. Differential considerations for a mass in this location include: Cystic hygroma, hemangioma, foreign body, hematoma (trauma/C-spine injury), adenopathy, lymphoma, Histiocytosis X, neurofibroma, or rhabdomyosarcoma.