Retropharyngeal abscess rpa is usually described as a disease of children. Retropharyngeal definition of retropharyngeal by medical. They occur mostly in immunocompromised patients or as a foreign body complication. Symptoms include fever, sore throat, odynophagia, and swelling in the neck down to the hyoid bone. Purulent collection within pharygeal spaces lateral pharynx, retropharynx, pretracheal spaces sources include sinuses and middle ear, teeth and tonsils, as well as salivary glands esp. Pdf laser ablation and management of a retropharyngeal. Retropharyngeal abscess can arise secondary to a dental infection. Fourteen children 45% had a preceding upper respiratory illness and four % had a prior history of pharyngeal. We report 5 cases of retropharyngeal abscess collected in the ent department of chu mohammed vi of marrakech, during a twoyear period december 2008 to december 2009. Introduction stridor of acute origin commonly termed croup is due to laryngeal or tracheal narrowing. Anatomical complexity and etiology med j malaysia vol 62 no 5 december 2007 415 medial displacement of the lateral pharyngeal wall and tonsil is a hallmark of a parapharyngeal space infection. Many infections are caused by a combination of bacteria. Use warm compresses to the area, at least 4 times a. A perianal abscess is a collection of pus just outside the anus.
Retropharyngeal abscess rpa produces the symptoms of sore throat, fever, neck stiffness, and stridor. From wikidata jump to navigation jump to search no description defined edit language label description also known as english parapharyngeal abscess no. Retropharyngeal abscess is a collection of pus in the tissues in the back of the throat. Conservative treatment o consider if cellulitis probable o may be appropriate for small abscess, no respiratory compromise, no trismus, no septicemia o fluids, analgesia, antibiotics o reassess in 1224 hours if not improved in 24 hours consider surgical. Retropharyngeal abscesses occur in the back of the throat. This space is divided by the styloid process into anterior and posterior compartments. Over 95% of the cases occurred in children under the age of 6.
A retropharyngeal abscess is medical situation where there is a pus abscess formation in the tissue located on the back of the patients throat. Retropharyngeal abscess ear, nose, and throat disorders. Three of these 10 children were neonates, only one of whom had a predisposing congenital lesion. The diagnosis is made through blood tests radiographic methods, and treatment must be conducted immediately, consisting of antibiotics and. The parapharyngeal pharyngomaxillary space is lateral to the superior pharyngeal. Retropharyngeal abscess msd manual consumer version. Retropharyngeal abscess, read about retropharyngeal.
Deep neck spaces and infection retropharyngeal abscess slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Retropharyngeal abscess rpa is an abscess located in the tissues in the back of the throat behind the posterior pharyngeal wall the retropharyngeal space. Parapharyngeal abscess in children five year retrospective study article pdf available in brazilian journal of otorhinolaryngology 756. Since the introduction of antibiotics, the incidence of parapharyngeal abscess secondary to tonsillitis and peritonsillar abscess has decreased dramatically.
Parapharyngeal abscess msd manual professional edition. A canine space infection is usually caused by maxillary cuspid infection that perforates the lateral cortex of the maxilla above the insertion of the leva. The retropharyngeal space extends from the base of the skull to the level of the t1 or t2 vertebra, and includes the space behind the muscles of the pharynx but in front of the prevertebral fascia. Parapharyngeal abscess definition of parapharyngeal. The causes can be viral laryngotracheobronchitis viral croup, acute epiglottitis, laryngeal diphtheria, retropharyngeal abscess, foreign body, allergic.
There is a median raphe of the buccopharyngeal fascia which is why the abscess is only limited on one part of the midline. Progression of the signs and symptoms is key as it pertains to inflammation and obstruction of the upper airways andor. Anatomical complexity and etiology article pdf available in the medical journal of malaysia 625. An abscess is a painful collection of pus that is caused by a bacterial infection. Rearrange individual pages or entire files in the desired order. Retropharyngeal abscess and mediastinitis in a wellappearin. Peritonsillar abscess peritonsillar abscess is a collection of pus located between the capsule of the palatine tonsil and the pharyngeal muscles. Hiv infection and tuberculosis are becoming more common causes in adults and children. Deep neck infections include the parapharyngeal abscess, the retropharyngeal abscess and submandibular abscess. Retropharyngeal abscess, read about retropharyngeal abscess. What is retropharyngeal abscesscausessymptomstreatment.
Retropharyngeal abscess rpa, is the collection of pus in retropharyngeal space. Parapharyngeal abscess may cause lifethreatening complications. Peritonsillar abscess and tonsillitis may result in parapharyngeal abscess. Anesthetic management of tuberculous retropharyngeal abscess. Case reports lee guan teik summary this paper deals with our experience oftwo cases of retropharyngeal abscess due to foreign body. All deep neck infections are considered emergencies because they have the potential. Occasionally, when the ct image reveals a large hypodense area, doctors may choose an option of immediate surgical drainage and antibiotic therapy. Obtain a ct scan of the neck with iv contrast when the findings on the lateral neck xray are equivocal but ct scan of the neck with iv contrast can also differentiate between retropharyngeal abscess and cellulitis. As kids get older, however, this throat infection can be accompanied by an unpleasant condition called a peritonsillar abscess a peritonsillar abscess is an area of pusfilled tissue at the back of the mouth, next to one of the tonsils.
In this video, we are going to see about acute retropharyngeal abscess. Retropharyngeal abscess can occur at any age, but most commonly affects children younger than 5 years of age. Abscesses are localized collection of pus surrounded by inflamed tissue. Retropharyngeal abscess and mediastinitis in a well. Retropharyngeal abscess most often affects children under age 5, but it can occur at any age. In this case report, we describe an adult case of retropharyngeal abscess who presented to us with symptoms of sore throat and dysphagia for 1 month. Although these two infections have some differing symptoms,bothusuallycausefever,sorethroat,anddifficulty eating. Parapharyngeal abscess information including symptoms, causes, diseases, symptoms, treatments, and other medical and health issues. Peritonsillar abscess university of missouri system. Oct 05, 2018 retropharyngeal abscess rpa produces the symptoms of sore throat, fever, neck stiffness, and stridor.
Fever is a common presenting chief complaint in the pediatric emergency department. Retropharyngeal abscess is generally caused during throat infection as an after effect of throat infection. Retropharyngeal abscess rpa is a neck infection involving abscess formation in the space between the prevertebral fascia and the constrictor muscles. A dental abscess is a collection of pus in the teeth or gums. Patients with retropharyngeal abscess almost always present with a bulging of the posterior pharyngeal wall. Jan 02, 2015 retropharyngeal abscess appears as a hypodense lesion in the retropharyngeal space with peripheral ring enhancement. A retropharyngeal abscess is an infection in one of the deep spaces of the neck. Foreign material, fibrin, and blood clot may predispose. Local trauma by foreign body ingestion was the aetiology.
Retropharyngeal abscess appears as a hypodense lesion in the retropharyngeal space with peripheral ring enhancement. Scottbrowns otorhinolaryngology, head and neck surgery. It is a serious medical condition, potentially fatal, and requires prompt diagnosis and treatment. The posterior compartment contains the carotid artery, internal. L, abscedere, to go away a suppurative infection of tissues adjacent to the pharynx, usually a complication of acute pharyngitis or tonsillitis. A retropharyngeal abscess is usually caused by a bacterial infection that has spread from the tonsils, throat, sinuses, adenoids, or nose.
Parapharyngeal abscess merck manuals professional edition. Jun 29, 2007 parapharyngeal abscesses volume 105 issue 12 d. To continue reading this article, you must log in with your personal, hospital, or group practice subscription. Definition o extension of tonsillar infection beyond the capsule with abscess formation usually above and behind the tonsil 2. Potential threat to airway should always be considered. Acute retropharyngeal abscess for medical students youtube. Retropharyngeal abscess appears in infancy and early childhood.
Once the abscess is identified, a trial of antibiotic therapy is begun. This can occur during or very soon after a throat infection. To show the role of ultrasound us in distinguishing retropharyngeal abscess from. Based on clinical and operative findings, these abscesses were categorized as retropharyngeal abscess 29 patients, parapharyngeal abscess 10 patients, ludwigs angina ncbi. Deep neck spaces and infection ent linkedin slideshare. Retropharyngeal abscess is a potentially lifethreatening condition which most commonly occurs among young children, and presents with fever, sore throat, and other symptoms associated with local, and sometimes systemic infection. Ct and ultrasound imaging of retropharyngeal abscesses in children charles m. Parapharyngeal abscesses are deep neck abscesses involving the parapharyngeal space. Presentation is variable, the first symptoms of a parapharyngeal abscess are similar to those of uncomplicated acute pharyngitis or tonsiliits fever, sore throat, nasal voice, dysphonia, cervical lymphadenopathy. Keep the area covered with a gauze dressing, which should be changed if it gets dirty.
This is a concise presentation for medical students especially from india. Retropharyngeal abscesses pediatrics clerkship the. Because of the advances in antibiotic therapy, the frequency of this disease has decreased considerably. Know the causes, symptoms, treatment, recovery, prognosis and complications of retropharyngeal abscess. One study reported 51 cases of this condition in adults from 19701995. Introduction retropharyngeal abscess is a rare, deep, space infection of the neck. Retropharyngeal abscess symptoms, diagnosis and treatment. The retropharyngeal space is found posterior to the esophageal wall and anterior to the prevertebral fascia. However, the incidence of rpa has decreased over the years with the advent of antibiotics coupled with improved medical care.
Because rpas typically occur in deep tissue, they are difficult to diagnose by physical examination alone. To study the circumstances of diagnosis, predisposing factors, bacteriology and therapeutic management of parapharyngeal abscesses. Contributors ac, as, pm, rmb, jcs and jss all contributed to case management and manuscript construction. If you continue browsing the site, you agree to the use of cookies on this website. It is a serious and occasionally lifethreatening infection due to the anatomic location and the potential for obstruction of the upper airway. Parapharyngeal abscess radiology reference article. A retropharyngeal abscess, or rpa, is a deep tissue neck infection. Alaani a1, griffiths h, minhas ss, olliff j, lee ab. Fourteen children 45% had a preceding upper respiratory illness and four % had a prior history of pharyngeal trauma or ingestion of. A person of any age can develop a parapharyngeal abscess, but it is most commonly seen in children and adolescents 1. Canine space abscess whether the canine space is a true fascial space or simply a muscular apartment is a matter for debate. Peritonsillar abscess is the most common deep infection of the head and neck, with an annual incidence of 30 cases per 100,000 persons in the united states. Exaggerated cervical lordosis inward curvature on a lateral neck radiograph is highly suggestive of a retropharyngeal abscess.
Retropharyngeal abscess etiology bmj best practice. Buccal space abscess with marked swelling of the cheek and minimal trismus initial radiology should include an ortho. Peritonsillar abscess is the most com mon deep infection of the head and neck in young adults, despite the widespread use of antibiotics for treating tonsillitis. This happens when you have an infection in your mouth. Trismus, drooling, dysphagia, and odynophagia also are observed commonly. This retrospective study over a period of 7 years concerned 16 patients hospitalized in an ent and head and neck surgery department for parapharyngeal abscess. Management of skin abscesses in the era of methicillinresistant staphylococcus aureus pdf. Of 31 children with retropharyngeal abscess treated at this hospital between 1954 and 1990, 17 55% were 12 months old or less and 10 32% less than 6 months. Nov 15, 2007 to study the circumstances of diagnosis, predisposing factors, bacteriology and therapeutic management of parapharyngeal abscesses. Retropharyngeal abscess may be result from an upper respiratory tract infection that causes an inflammation in the retropharyngeal nodes, which will then lead to the formation of pus and develop into an abscess. Parapharyngeal abscess definition of parapharyngeal abscess. All patients were treated by intravenous antibiotics and steroids for. Rare condition, which can be a lifethreatening infection if not detected early. Almost always a complication of acute tonsillitis 3.
Parapharyngeal abscesses the journal of laryngology. Infected material pus builds up in the space around the tissues at the back of the throat. A parapharyngeal abscess is a deep neck space abscess of the parapharyngeal space or pharyngomaxillary space, which is lateral to the superior pharyngeal constrictor muscle en. Several studies have reported that over 95% of rpa cases occur in children under the age of 6 years 1, 2, 3. An abscess is a localized collection of pus often caused by bacteria such as staphyloccus aureus. A parapharyngeal abscess is a deep neck space abscess of the parapharyngeal space or pharyngomaxillary space, which is lateral to the superior pharyngeal constrictor muscle and medial to the masseter muscle. If this trial fails, surgical drainage of the pus collection is the next step. Ct and ultrasound imaging of retropharyngeal abscesses in. Rpa is a relatively uncommon illness, and therefore may not receive early diagnosis in children presenting with. Jul 01, 2015 deep neck infections include the parapharyngeal abscess, the retropharyngeal abscess and submandibular abscess. Retropharyngeal abscesses are most frequently encountered in children, with 75% of cases occurring before the age of 5 years, and often in the first year of life.
In adults, retropharyngeal abscesses are rare in adults and can occur as a result of local trauma, such as foreign body ingestion fishbone, or instrumental procedures laryngoscopy, endotracheal intubation, feeding tube placement, etc. Dont rule out retropharyngeal abscess in sore throats. Retropharyngeal abscess an overview sciencedirect topics. Patients may prefer to lay supine to prevent abscess and edematous posterior wall to collapse into airway, so patients should not be forced to sit up. Lots of kids get tonsillitis an infection of the tonsils, especially younger kids. Infection can spread to mediastinum and cause necrotizing mediastinitis. An abscess is a collection of pus that has built up within the tissue of the body. Retropharyngeal abscess fkc chu retropharyngeal abscess is a condition commonly seen in children but not so common in adult. Acute stridor in childhood, retropharyngeal abscess. Retropharyngeal abscess is a potentially lifethreatening infection involving the retropharyngeal space which requires prompt diagnosis and aggressive therapy. We report the case of a wellappearing 11monthold female with 2 weeks of daily fevers who was found to have an extensive retropharyngeal abscess with mediastinal and extrapleural extension. Retropharyngeal abscess occurs less commonly today than in the past because of the widespread use of antibiotics for suppurative upper respiratory infections.
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