2015Bengal Journal of Otolaryngology and Head Neck SurgeryOpen access

Adult retropharyngeal abscess

Saumendra Nath Bandopadhyay, Dwaipayan Mukherjee, Diptanshu Mukherjee, Swagatam Banerjee, Shubhra Kanti Sen

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Abstract

ABSTRACTIntroductionThe proportion of adults suffering from retropharyngeal abscess (RPA) has increased in comparison to children.Materials and methodsEight cases of adult retropharyngeal abscess were reviewed. The diagnostic criteria were radiological evidence of widening of pre-vertebral soft tissue shadow and presence of pus in the swelling.ResultsSore throat, fever, muffled speech, painful swallow and stiffness of the neck were common presenting symptoms. Lateral X-ray of the neck was diagnostic. Commonest organism isolated was Streptococcus pyogenes. Airway obstruction was the commonest complication.DiscussionMost of the patients had history of trauma prior to the development of RPA. CT scan has an important role in planning the management in addition to lateral X-ray of the neck. Transoral surgical drainage in association with antibiotics is the treatment of choice in abscesses confined to the retropharyngeal space.ConclusionTuberculosis is no longer the commonest cause of adult retropharyngeal abscess. Sore throat or dysphagia, disproportionate to clinical findings in the throat should arouse suspicion of RPA. Early intervention with antibiotics reduces the chances of the development of complications.

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ABSTRACTIntroductionThe proportion of adults suffering from retropharyngeal abscess (RPA) has increased in comparison to children.Materials and methodsEight cases of adult retropharyngeal abscess were reviewed. The diagnostic criteria were radiological evidence of widening of pre-vertebral soft tissue shadow and presence of pus in the swelling.ResultsSore throat, fever, muffled speech, painful swallow and stiffness of the neck were common presenting symptoms. Lateral X-ray of the neck was diagnostic. Commonest organism isolated was Streptococcus pyogenes. Airway obstruction was the commonest complication.DiscussionMost of the patients had history of trauma prior to the development of RPA. CT scan has an important role in planning the management in addition to lateral X-ray of the neck. Transoral surgical drainage in association with antibiotics is the treatment of choice in abscesses confined to the retropharyngeal space.ConclusionTuberculosis is no longer the commonest cause of adult retropharyngeal abscess. Sore throat or dysphagia, disproportionate to clinical findings in the throat should arouse suspicion of RPA. Early intervention with antibiotics reduces the chances of the development of complications.

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Available abstract

ABSTRACTIntroductionThe proportion of adults suffering from retropharyngeal abscess (RPA) has increased in comparison to children.Materials and methodsEight cases of adult retropharyngeal abscess were reviewed. The diagnostic criteria were radiological evidence of widening of pre-vertebral soft tissue shadow and presence of pus in the swelling.ResultsSore throat, fever, muffled speech, painful swallow and stiffness of the neck were common presenting symptoms. Lateral X-ray of the neck was diagnostic. Commonest organism isolated was Streptococcus pyogenes. Airway obstruction was the commonest complication.DiscussionMost of the patients had history of trauma prior to the development of RPA. CT scan has an important role in planning the management in addition to lateral X-ray of the neck. Transoral surgical drainage in association with antibiotics is the treatment of choice in abscesses confined to the retropharyngeal space.ConclusionTuberculosis is no longer the commonest cause of adult retropharyngeal abscess. Sore throat or dysphagia, disproportionate to clinical findings in the throat should arouse suspicion of RPA. Early intervention with antibiotics reduces the chances of the development of complications.

Key concepts: Medicine, Retropharyngeal abscess, Retropharyngeal space, Sore throat, Dysphagia, Throat, Abscess, Surgery

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