Table of ContentsView AllTable of ContentsIn ChildrenBacteria and Lymph NodesSymptomsDiagnostic TestsTreatmentComplicationsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
In Children
Bacteria and Lymph Nodes
Symptoms
Diagnostic Tests
Treatment
Complications
Frequently Asked Questions
The development of a retropharyngeal abscess is a medical emergency that can be life-threatening. Urgent treatment is necessary because this abscess can impact your ability to swallow and breathe. In this article, learn about the common causes that lead to a retropharyngeal abscess and how it is treated.
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Retropharyngeal Abscess in Children
Children younger than age 5 are at the highest risk for developing a retropharyngeal abscess.However, anyone can develop one.
The most common cause of a retropharyngeal abscess in young children is a prior infection, like an ear infection, sinus infection, or throat infection.An injury (such as swallowing an object) or trauma to the neck or throat can also result in an abscess.
An abscess is a walled-off cavity filled withpus—a collection of bacteria, debris, and white blood cells. It can be difficult for the immune system to destroy bacteria inside an abscess.
What Does Retropharyngeal Mean?The retropharyngeal space is located behind thepharynx(throat),larynx(voice box), andtrachea(windpipe), between the base of the skull and where the trachea branches to become thebronchithat supply each lung.A line of connected lymph nodes is present in this space in children, but often this disappears with age.
What Does Retropharyngeal Mean?
The retropharyngeal space is located behind thepharynx(throat),larynx(voice box), andtrachea(windpipe), between the base of the skull and where the trachea branches to become thebronchithat supply each lung.A line of connected lymph nodes is present in this space in children, but often this disappears with age.
Risk in Adults
A retropharyngeal abscess is less common in adults compared to children. The reasoning behind this lies in how the body develops and changes as a person grows older.
With age, the lymph nodes behind the throat that are most often infected regress and disappear.Usually, this process starts around the age of 5. As a result, older children and adults are far less likely to develop a retropharyngeal abscess compared to young children.
However, there is always still a possibility that a retropharyngeal abscess can develop in an adult. For instance, it has been seen as a rare complication of COVID-19.
Lymph nodes are located throughout the body and play an important role in preventing and responding to infections.The lymph nodes are a source of white blood cells, which help respond to infectious organisms, such as bacteria and viruses.
When an infection occurs, the lymph nodes often swell as the immune system ramps up a defensive response. While lymph node swelling is a positive action the body takes in response to an infection, it can sometimes cause additional problems.
One issue occurs when bacteria native to the body enter the swollen tissues and cause an additional infection. These bacteria natively live in the mouth or on the skin without causing any trouble. However, if the bacteria move into a lymph node, there is a small possibility they can multiply and cause an abscess.
Symptoms of a retropharyngeal abscess include:
These symptoms are nonspecific, meaning they also can occur with other conditions. However, if you or your child experiences these symptoms, get prompt medical attention. A retropharyngeal abscess is serious.
The diagnostic tests for the evaluation of a retropharyngeal abscess are a combination of laboratory and imaging tests. The combination of tests can determine if there is an infection, and imaging can detect the location of the abscess. Commonly used laboratory tests include:
Commonly used imaging tests may include:
Once an abscess develops, it can be difficult for the body’s immune system to clear out the infection. The treatment for a retropharyngeal abscess often requires intravenous (IV) antibiotics to treat the bacterial infection, as well as a needle aspiration or surgical drainage of the abscess.
Smaller abscesses may only need antibiotics, but often these are given intravenously (within a vein) in a hospital setting.
Antibiotic Resistance
Antibiotic resistance—when germs develop the ability to not respond to drugs made to kill them—is a growing issue in the treatment of infections.Since several types of bacteria can often be involved in a retropharyngeal abscess, a broad-spectrum antibiotic that can kill multiple types of bacteria is often required.
Broad-spectrum antibiotics are extremely useful for the treatment of infections. However, they can carry a risk of bacteria developing antibiotic resistance. Your healthcare team may start with a broad-spectrum antibiotic and then choose one that matches the resistance pattern of the bacteria identified in the abscess.
Life-Threatening Complications
Maintaining a clear airway is critical in the treatment of a retropharyngeal abscess. In some cases, emergency intubation is required, and a tube is placed into the airway to support breathing.Intubation is necessary until the abscess can be appropriately treated and the airway is not blocked.
Summary
Frequently Asked QuestionsA retropharyngeal abscess is always a medical emergency that requires prompt treatment. If the abscess impacts the airway, then the ability to breathe can be disrupted, which can be life-threatening.Learn MoreWhat Is Intubation?It is not common for adults to develop abscesses in the throat that progress to retropharyngeal abscesses. In children, retropharyngeal abscesses are more common.Learn MoreThroat Pain CausesA retropharyngeal abscess can make lymph nodes swell. In some cases, swollen lymph nodes may contribute to the development of a retropharyngeal abscess.Learn MoreSwollen GlandsThe treatment of a retropharyngeal abscess often requires a multidisciplinary team. Doctors with training in pediatrics (if a child is the patient), infectious diseases, head and neck surgery, and ear, nose, and throat (ENT) conditions may be involved in the treatment of a retropharyngeal abscess.Learn MorePediatric ENT Disorders
A retropharyngeal abscess is always a medical emergency that requires prompt treatment. If the abscess impacts the airway, then the ability to breathe can be disrupted, which can be life-threatening.Learn MoreWhat Is Intubation?
A retropharyngeal abscess is always a medical emergency that requires prompt treatment. If the abscess impacts the airway, then the ability to breathe can be disrupted, which can be life-threatening.
Learn MoreWhat Is Intubation?
It is not common for adults to develop abscesses in the throat that progress to retropharyngeal abscesses. In children, retropharyngeal abscesses are more common.Learn MoreThroat Pain Causes
It is not common for adults to develop abscesses in the throat that progress to retropharyngeal abscesses. In children, retropharyngeal abscesses are more common.
Learn MoreThroat Pain Causes
A retropharyngeal abscess can make lymph nodes swell. In some cases, swollen lymph nodes may contribute to the development of a retropharyngeal abscess.Learn MoreSwollen Glands
A retropharyngeal abscess can make lymph nodes swell. In some cases, swollen lymph nodes may contribute to the development of a retropharyngeal abscess.
Learn MoreSwollen Glands
The treatment of a retropharyngeal abscess often requires a multidisciplinary team. Doctors with training in pediatrics (if a child is the patient), infectious diseases, head and neck surgery, and ear, nose, and throat (ENT) conditions may be involved in the treatment of a retropharyngeal abscess.Learn MorePediatric ENT Disorders
The treatment of a retropharyngeal abscess often requires a multidisciplinary team. Doctors with training in pediatrics (if a child is the patient), infectious diseases, head and neck surgery, and ear, nose, and throat (ENT) conditions may be involved in the treatment of a retropharyngeal abscess.
Learn MorePediatric ENT Disorders
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.LeRiger MM, Miler V, Tobias JD, Raman VT, Elmaraghy CA, Jatana KR.Potential for severe airway obstruction from pediatric retropharyngeal abscess.Int Med Case Rep J. 2017;10:381-384. doi:10.2147/IMCRJ.S146661Stanford Children’s Health.Neck abscess.Nemours KidsHealth.Retropharyngeal abscess.BMJ Best Practice.Retropharyngeal abscess.Georget E, Gauthier A, Brugel L, et al.Acute cervical lymphadenitis and infections of the retropharyngeal and parapharyngeal spaces in children.BMC Ear Nose Throat Disord. 2014;14:8. doi:10.1186/1472-6815-14-8Awobajo MD, Agarwal AN, Hackman SD.Retropharyngeal abscess- An unusual complication in a COVID-19 patient.Otolaryngol Case Rep. 2021;20:100312. doi:10.1016/j.xocr.2021.100312Centers for Disease Control and Prevention.Know the signs and symptoms of infection.Sanz Sánchez CI, Morales Angulo C.Retropharyngeal abscess. clinical review of twenty-five years.Acta Otorrinolaringol Esp (Engl Ed). 2021;72(2):71-79. doi:10.1016/j.otorri.2020.01.005Souza DL, Cabrera D, Gilani WI, et al.Comparison of medical versus surgical management of peritonsillar abscess: a retrospective observational study.Laryngoscope. 2016;126(7):1529-1534. doi:10.1002/lary.25960Centers for Disease Control and Prevention.About antibiotic resistance.Dawes LC, Bova R, Carter P.Retropharyngeal abscess in children.ANZ J Surg. 2002;72(6):417-420. doi:10.1046/j.1445-2197.2002.02432.x
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.LeRiger MM, Miler V, Tobias JD, Raman VT, Elmaraghy CA, Jatana KR.Potential for severe airway obstruction from pediatric retropharyngeal abscess.Int Med Case Rep J. 2017;10:381-384. doi:10.2147/IMCRJ.S146661Stanford Children’s Health.Neck abscess.Nemours KidsHealth.Retropharyngeal abscess.BMJ Best Practice.Retropharyngeal abscess.Georget E, Gauthier A, Brugel L, et al.Acute cervical lymphadenitis and infections of the retropharyngeal and parapharyngeal spaces in children.BMC Ear Nose Throat Disord. 2014;14:8. doi:10.1186/1472-6815-14-8Awobajo MD, Agarwal AN, Hackman SD.Retropharyngeal abscess- An unusual complication in a COVID-19 patient.Otolaryngol Case Rep. 2021;20:100312. doi:10.1016/j.xocr.2021.100312Centers for Disease Control and Prevention.Know the signs and symptoms of infection.Sanz Sánchez CI, Morales Angulo C.Retropharyngeal abscess. clinical review of twenty-five years.Acta Otorrinolaringol Esp (Engl Ed). 2021;72(2):71-79. doi:10.1016/j.otorri.2020.01.005Souza DL, Cabrera D, Gilani WI, et al.Comparison of medical versus surgical management of peritonsillar abscess: a retrospective observational study.Laryngoscope. 2016;126(7):1529-1534. doi:10.1002/lary.25960Centers for Disease Control and Prevention.About antibiotic resistance.Dawes LC, Bova R, Carter P.Retropharyngeal abscess in children.ANZ J Surg. 2002;72(6):417-420. doi:10.1046/j.1445-2197.2002.02432.x
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
LeRiger MM, Miler V, Tobias JD, Raman VT, Elmaraghy CA, Jatana KR.Potential for severe airway obstruction from pediatric retropharyngeal abscess.Int Med Case Rep J. 2017;10:381-384. doi:10.2147/IMCRJ.S146661Stanford Children’s Health.Neck abscess.Nemours KidsHealth.Retropharyngeal abscess.BMJ Best Practice.Retropharyngeal abscess.Georget E, Gauthier A, Brugel L, et al.Acute cervical lymphadenitis and infections of the retropharyngeal and parapharyngeal spaces in children.BMC Ear Nose Throat Disord. 2014;14:8. doi:10.1186/1472-6815-14-8Awobajo MD, Agarwal AN, Hackman SD.Retropharyngeal abscess- An unusual complication in a COVID-19 patient.Otolaryngol Case Rep. 2021;20:100312. doi:10.1016/j.xocr.2021.100312Centers for Disease Control and Prevention.Know the signs and symptoms of infection.Sanz Sánchez CI, Morales Angulo C.Retropharyngeal abscess. clinical review of twenty-five years.Acta Otorrinolaringol Esp (Engl Ed). 2021;72(2):71-79. doi:10.1016/j.otorri.2020.01.005Souza DL, Cabrera D, Gilani WI, et al.Comparison of medical versus surgical management of peritonsillar abscess: a retrospective observational study.Laryngoscope. 2016;126(7):1529-1534. doi:10.1002/lary.25960Centers for Disease Control and Prevention.About antibiotic resistance.Dawes LC, Bova R, Carter P.Retropharyngeal abscess in children.ANZ J Surg. 2002;72(6):417-420. doi:10.1046/j.1445-2197.2002.02432.x
LeRiger MM, Miler V, Tobias JD, Raman VT, Elmaraghy CA, Jatana KR.Potential for severe airway obstruction from pediatric retropharyngeal abscess.Int Med Case Rep J. 2017;10:381-384. doi:10.2147/IMCRJ.S146661
Stanford Children’s Health.Neck abscess.
Nemours KidsHealth.Retropharyngeal abscess.
BMJ Best Practice.Retropharyngeal abscess.
Georget E, Gauthier A, Brugel L, et al.Acute cervical lymphadenitis and infections of the retropharyngeal and parapharyngeal spaces in children.BMC Ear Nose Throat Disord. 2014;14:8. doi:10.1186/1472-6815-14-8
Awobajo MD, Agarwal AN, Hackman SD.Retropharyngeal abscess- An unusual complication in a COVID-19 patient.Otolaryngol Case Rep. 2021;20:100312. doi:10.1016/j.xocr.2021.100312
Centers for Disease Control and Prevention.Know the signs and symptoms of infection.
Sanz Sánchez CI, Morales Angulo C.Retropharyngeal abscess. clinical review of twenty-five years.Acta Otorrinolaringol Esp (Engl Ed). 2021;72(2):71-79. doi:10.1016/j.otorri.2020.01.005
Souza DL, Cabrera D, Gilani WI, et al.Comparison of medical versus surgical management of peritonsillar abscess: a retrospective observational study.Laryngoscope. 2016;126(7):1529-1534. doi:10.1002/lary.25960
Centers for Disease Control and Prevention.About antibiotic resistance.
Dawes LC, Bova R, Carter P.Retropharyngeal abscess in children.ANZ J Surg. 2002;72(6):417-420. doi:10.1046/j.1445-2197.2002.02432.x
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