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Retropharyngeal Space Abscess
Bernadette L. Koch, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Retropharyngeal space (RPS): Midline space posterior to pharyngeal mucosa & cervical esophagus from skull base to T3 vertebral level in mediastinum
                • RPS abscess: Extranodal purulent fluid collection in RPS

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Ho ML et al: The ABCs (airway, blood vessels, and compartments) of pediatric neck infections and masses. AJR Am J Roentgenol. 1-10, 2016
                                              2. Wilson CD et al: Retrospective review of management and outcomes of pediatric descending mediastinitis. Otolaryngol Head Neck Surg. 155(1):155-9, 2016
                                              3. Novis SJ et al: Pediatric deep space neck infections in U.S. children, 2000-2009. Int J Pediatr Otorhinolaryngol. 78(5):832-6, 2014
                                              4. Schott CK et al: A pain in the neck: non-traumatic adult retropharyngeal abscess. J Emerg Med. 44(2):329-31, 2013
                                              5. Abdel-Haq N et al: Retropharyngeal abscess in children: the rising incidence of methicillin-resistant Staphylococcus aureus. Pediatr Infect Dis J. 31(7):696-9, 2012
                                              6. Baker KA et al: Use of computed tomography in the emergency department for the diagnosis of pediatric peritonsillar abscess. Pediatr Emerg Care. 28(10):962-5, 2012
                                              7. Debnam JM et al: Retropharyngeal and prevertebral spaces: anatomic imaging and diagnosis. Otolaryngol Clin North Am. 45(6):1293-310, 2012
                                              8. Maroldi R et al: Emergency imaging assessment of deep neck space infections. Semin Ultrasound CT MR. 33(5):432-42, 2012
                                              9. Reilly BK et al: Retropharyngeal abscess: diagnosis and treatment update. Infect Disord Drug Targets. 12(4):291-6, 2012
                                              10. Virk JS et al: Analysing lateral soft tissue neck radiographs. Emerg Radiol. 19(3):255-60, 2012
                                              11. Wang KY et al: Retropharyngeal abscess with descending necrotizing mediastinitis. J Emerg Med. 43(1):114-5, 2012
                                              12. Wong DK et al: To drain or not to drain - management of pediatric deep neck abscesses: a case-control study. Int J Pediatr Otorhinolaryngol. 76(12):1810-3, 2012
                                              13. Hoang JK et al: Multiplanar CT and MRI of collections in the retropharyngeal space: is it an abscess? AJR Am J Roentgenol. 196(4):W426-32, 2011
                                              14. Byramji A et al: Fatal retropharyngeal abscess: a possible marker of inflicted injury in infancy and early childhood. Forensic Sci Med Pathol. 5(4):302-6, 2009
                                              15. Palacios E et al: Nontraumatic retropharyngeal abscess complicated by cervical osteomyelitis and epidural abscess in post-Katrina New Orleans: four cases. Ear Nose Throat J. 88(7):E14, 2009
                                              16. Pelaz AC et al: Conservative treatment of retropharyngeal and parapharyngeal abscess in children. J Craniofac Surg. 20(4):1178-81, 2009
                                              17. Shefelbine SE et al: Pediatric retropharyngeal lymphadenitis: differentiation from retropharyngeal abscess and treatment implications. Otolaryngol Head Neck Surg. 136(2):182-8, 2007
                                              18. Wang LF et al: Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases. Am J Otolaryngol. 24(2):111-7, 2003
                                              19. Stone ME et al: Correlation between computed tomography and surgical findings in retropharyngeal inflammatory processes in children. Int J Pediatr Otorhinolaryngol. 49(2):121-5, 1999
                                              20. Hudgins PA et al: Internal carotid artery narrowing in children with retropharyngeal lymphadenitis and abscess. AJNR Am J Neuroradiol. 19(10):1841-3, 1998
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Definitions

                                                            • Retropharyngeal space (RPS): Midline space posterior to pharyngeal mucosa & cervical esophagus from skull base to T3 vertebral level in mediastinum
                                                            • RPS abscess: Extranodal purulent fluid collection in RPS

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Ultrasonographic Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Ho ML et al: The ABCs (airway, blood vessels, and compartments) of pediatric neck infections and masses. AJR Am J Roentgenol. 1-10, 2016
                                                                                          2. Wilson CD et al: Retrospective review of management and outcomes of pediatric descending mediastinitis. Otolaryngol Head Neck Surg. 155(1):155-9, 2016
                                                                                          3. Novis SJ et al: Pediatric deep space neck infections in U.S. children, 2000-2009. Int J Pediatr Otorhinolaryngol. 78(5):832-6, 2014
                                                                                          4. Schott CK et al: A pain in the neck: non-traumatic adult retropharyngeal abscess. J Emerg Med. 44(2):329-31, 2013
                                                                                          5. Abdel-Haq N et al: Retropharyngeal abscess in children: the rising incidence of methicillin-resistant Staphylococcus aureus. Pediatr Infect Dis J. 31(7):696-9, 2012
                                                                                          6. Baker KA et al: Use of computed tomography in the emergency department for the diagnosis of pediatric peritonsillar abscess. Pediatr Emerg Care. 28(10):962-5, 2012
                                                                                          7. Debnam JM et al: Retropharyngeal and prevertebral spaces: anatomic imaging and diagnosis. Otolaryngol Clin North Am. 45(6):1293-310, 2012
                                                                                          8. Maroldi R et al: Emergency imaging assessment of deep neck space infections. Semin Ultrasound CT MR. 33(5):432-42, 2012
                                                                                          9. Reilly BK et al: Retropharyngeal abscess: diagnosis and treatment update. Infect Disord Drug Targets. 12(4):291-6, 2012
                                                                                          10. Virk JS et al: Analysing lateral soft tissue neck radiographs. Emerg Radiol. 19(3):255-60, 2012
                                                                                          11. Wang KY et al: Retropharyngeal abscess with descending necrotizing mediastinitis. J Emerg Med. 43(1):114-5, 2012
                                                                                          12. Wong DK et al: To drain or not to drain - management of pediatric deep neck abscesses: a case-control study. Int J Pediatr Otorhinolaryngol. 76(12):1810-3, 2012
                                                                                          13. Hoang JK et al: Multiplanar CT and MRI of collections in the retropharyngeal space: is it an abscess? AJR Am J Roentgenol. 196(4):W426-32, 2011
                                                                                          14. Byramji A et al: Fatal retropharyngeal abscess: a possible marker of inflicted injury in infancy and early childhood. Forensic Sci Med Pathol. 5(4):302-6, 2009
                                                                                          15. Palacios E et al: Nontraumatic retropharyngeal abscess complicated by cervical osteomyelitis and epidural abscess in post-Katrina New Orleans: four cases. Ear Nose Throat J. 88(7):E14, 2009
                                                                                          16. Pelaz AC et al: Conservative treatment of retropharyngeal and parapharyngeal abscess in children. J Craniofac Surg. 20(4):1178-81, 2009
                                                                                          17. Shefelbine SE et al: Pediatric retropharyngeal lymphadenitis: differentiation from retropharyngeal abscess and treatment implications. Otolaryngol Head Neck Surg. 136(2):182-8, 2007
                                                                                          18. Wang LF et al: Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases. Am J Otolaryngol. 24(2):111-7, 2003
                                                                                          19. Stone ME et al: Correlation between computed tomography and surgical findings in retropharyngeal inflammatory processes in children. Int J Pediatr Otorhinolaryngol. 49(2):121-5, 1999
                                                                                          20. Hudgins PA et al: Internal carotid artery narrowing in children with retropharyngeal lymphadenitis and abscess. AJNR Am J Neuroradiol. 19(10):1841-3, 1998