SEARCH RESULTS FOR: Retropharyngeal-Abscess

Retropharyngeal Abscess

Retropharyngeal Abscess: Pathogenesis and clinical findings Viral upper respiratory tract infection (URTI) Secondary bacterial infection Bacterial URTI Dental infection Spinal discitis or osteomyelitis Retropharyngeal lymph nodes drain bacteria & debris from nasopharynx, adenoids, posterior paranasal sinuses & middle ear (these lymph nodes involute before puberty) Direct expansion into retropharyngeal space Microorganisms (classically polymicrobial), leukocytes & tissue debris secondary to infection accumulate in retropharyngeal space Retropharyngeal Abscess Collection of pus that develops in the retropharyngeal space between the buccopharyngeal fascia (anterior) & alar fascia (posterior) Inflammatory response Local tissue edema Worsening of mass effect Mass effect of abscess results in displacement or compression of trachea, esophagus or larynx Anterior & posterior cervical lymph nodes become inflamed Cervical lymphadenopathy Narrowing of airway lumen Compression of larynx &/or laryngeal nerves Neck swelling Neck extensor muscles become inflamed Partial Complete Pain with neck obstruction obstruction extension Dysphonia (hoarseness) Systemic cytokine release disrupts hypothalamic thermoregulation Asphyxiation Fever Narrowing of esophageal lumen Turbulent airflow through narrowed upper respiratory tract Insufficient tissue perfusion promotes compensatory ↑ respiratory rate ↓ Intrathoracic pressure Dysphagia (difficulty swallowing) Odynophagia (pain with swallowing) Difficulty swallowing oral secretions Stridor Tachypnea Intercostal retractions Drooling Legend: Oropharyngeal trauma Retropharyngeal space is inoculated with bacteria during traumatic injury Author: Stephanie de Waal* Reviewers: Annie Pham Taylor Krawec Michelle J. Chen Emily J. Doucette Danielle Nelson* *MD at time of publication Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Disruption of abscess results in rupture Mass effect partially relieved positionally Bacteria enters bloodstream Abscess contents drain into lower respiratory tract Sniffing position Sepsis (leaning forwards Aspiration pneumonia with slight neck extension) Spread of infection through alar fascia into “danger space” (region posterior to retropharyngeal space connecting to mediastinum) Spread of infection into mediastinum Descending necrotizing mediastinitis Published Aug 4, 2025 on www.thecalgaryguide.com