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Retropharyngeal Abscess, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Deep tissue infection of the retropharyngeal space:

    • Potential space bound anteriorly by buccopharyngeal fascia, posteriorly by alar fascia, superiorly by skull base, inferiorly by fus...

Diagnosis

Signs and Symptoms

May differ between adults and children 

History

  • Most common:

    • Sore throat

    • Neck pain/stiffness

    • Odynophagia

    • Dysphagia

    • Fever

  • Additional presenting symptoms:

    • Stridor, dyspnea

    • Muffled voic...

Treatment

Pre-Hospital

  • Keep child in position of comfort:

    • Forcing child to sit up or flex neck may occlude airway

  • Pulse oximetry, cardiac monitor

  • Supplemental oxygen

  • Adequate hydration

  • Suction, endotracheal...

Follow-Up

Disposition

Admission Criteria

  • All patients with retropharyngeal abscess should be admitted to the hospital for IV antibiotics and possible surgical drainage

  • Criteria for surgical drainage:

    • Airw...

Pearls and Pitfalls

  • Diagnosis should be considered in all children who present with fever, stiff neck, or dysphagia:

    • High clinical suspicion is required in children, as they present with nonspecific si...

Additional Reading

Codes

ICD9

478.24 Retropharyngeal abscess 

ICD10

J39.0 Retropharyngeal and parapharyngeal abscess 

SNOMED

  • 18099001 retropharyngeal abscess (disorder)

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