Retropharyngeal abscess following tracheal intubation

Acute retropharyngeal abscess in children

Due to the wide availability of effective antibiotics, acute retropharyngeal abscesses have become increasingly rare. This is a retrospective report of ten children with this condition, managed over a 10-year period. Nearly all were aged 12 months or less and presented only when respiratory obstruction had developed. Owing to administration of antibiotics at home, cultures of pus specimens were sterile in most cases. The retropharyngeal space was widened on lateral, plan cervical radiography in five children. Four had drainage by external cervical incision, and in four drainage was by mouth, all under general anaesthesia. Tracheostomy was necessary in one child who developed respiratory obstruction and the abscess was drained by needle aspiration. One child died before drainage of the abscess. Parenteral antibiotics were administered also for 5 days. There was no recurrence in any case. Laryngeal spasm occurred post-operatively in two children, leading to death in one. Overall, two children died. The features and management of the disease are reviewed briefly to re-awaken awareness of the condition, especially in developing countries where it is most likely to be seen at the present time.

Adult retropharyngeal abscess: a case report and review of the literature

The case of an 18-yr-old otherwise healthy adult with retropharyngeal abscess (RPA) presenting with sore throat and syncope is reported. The case illustrates that sore throat with symptoms out of proportion to oropharyngeal findings should prompt a search for pathology other than simple pharyngitis. A literature search for case reports of RPA in adults was done to derive characterizations about this disease. Adult RPA patients present with sore throat, dysphagia, neck pain and, less commonly, stridor. Adult RPA occurs as a complication of procedures or blunt trauma to the neck, or spread of infection from an adjacent focus. The incidence of underlying disease causing immunosuppression is high. RPA in adults without history of preceding trauma or coexistent illness is unusual.