Retropharyngeal abscess (RPA) is an
abscess
An abscess is a collection of pus that has built up within the tissue of the body, usually caused by bacterial infection. Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pre ...
located in the tissues in the back of the throat behind the posterior pharyngeal wall (the
retropharyngeal space
The retropharyngeal space (abbreviated as "RPS") is a potential space and deep compartment of the head and neck situated posterior to the pharynx. The RPS is bounded anteriorly by the buccopharyngeal fascia, posteriorly by the alar fascia, and l ...
). Because RPAs typically occur in deep tissue, they are difficult to diagnose by
physical examination
In a physical examination, medical examination, clinical examination, or medical checkup, a medical practitioner examines a patient for any possible medical signs or symptoms of a Disease, medical condition. It generally consists of a series of ...
alone. RPA is a relatively uncommon illness, and therefore may not receive early diagnosis in children presenting with
stiff neck,
malaise
In medicine, malaise is a feeling of general discomfort, uneasiness or lack of wellbeing and often the first sign of an infection or other disease. It is considered a vague termdescribing the state of simply not feeling well. The word has exist ...
,
difficulty swallowing
Dysphagia is difficulty in swallowing. Although classified under " symptoms and signs" in ICD-10, in some contexts it is classified as a condition in its own right.
It may be a sensation that suggests difficulty in the passage of solids or li ...
, or other symptoms listed below. Early diagnosis is key, while a delay in diagnosis and treatment may lead to death.
Parapharyngeal space communicates with retropharyngeal space and an infection of retropharyngeal space can pass down behind the
esophagus
The esophagus (American English), oesophagus (British English), or œsophagus (Œ, archaic spelling) (American and British English spelling differences#ae and oe, see spelling difference) all ; : ((o)e)(œ)sophagi or ((o)e)(œ)sophaguses), c ...
into the
mediastinum
The mediastinum (from ;: mediastina) is the central compartment of the thoracic cavity. Surrounded by loose connective tissue, it is a region that contains vital organs and structures within the thorax, mainly the heart and its vessels, the eso ...
. RPAs can also occur in adults of any age.
RPA can lead to
airway obstruction
Airway obstruction is a blockage of respiration in the airway that hinders the free flow of air. Airway obstructions can occur either in the upper airway or lower airway. The upper airway consists of the nose, throat, and larynx. The lower ai ...
or
sepsis
Sepsis is a potentially life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs.
This initial stage of sepsis is followed by suppression of the immune system. Common signs and s ...
– both life-threatening emergencies.
Fatalities normally occur from patients not receiving treatment immediately and suffocating prior to knowing that anything serious was wrong.
Signs and symptoms
Signs and symptoms may include the following
stiff neck (limited neck mobility or
torticollis
Torticollis, also known as wry neck, is an extremely painful, dystonic condition defined by an abnormal, asymmetrical head or neck position, which may be due to a variety of causes. The term ''torticollis'' is derived .
The most common case ha ...
), some form of