Retropharyngeal Abscess

By | June 8, 2022

Retropharyngeal abscess can result from bacterial infection or after injury from a foreign body in the upper airway. The lymph nodes in the neck area can then melt away with pus and cause an abscess. This abscess then forms on the back back wall of the throat. The abscess must be treated promptly and adequately, which usually requires surgical intervention.

What is a retropharyngeal abscess?

A retropharyngeal abscess is when pus has formed in the tissue behind the throat. This accumulation of pus often occurs after a sore throat. Children under the age of five are often affected, but adults of all ages can also develop an abscess. The accumulation of pus on the back of the throat wall is due to a bacterial infection. For about messie syndrome, please visit

This causes general difficulty in swallowing, pain, fever, and difficulty breathing. A diagnosis can often be made based on the symptoms. An x- ray or computed tomography of the neck can provide a reliable diagnosis. The patient should then receive immediate treatment, from which he usually recovers quickly. In most cases, the retropharyngeal abscess is surgically opened and drained. The actual infection is treated with an antibiotic.


The cause of the retropharyngeal abscess is often the reduction or complete regression of the lymph nodes on the back of the throat. Children are affected more often than adults because the shrinkage begins at the age of four to five years. The abscess usually forms when the palate or adenoids become bacterially infected.

The throat, sinuses and nasal polyps can also become infected with bacteria. In most cases, the bacteria spread through the nose. Most infections are caused by the combination of several different bacteria. However, an abscess can also develop as a result of an injury to the rear pharyngeal wall. Injuries can be caused, for example, by swallowing sharp objects or food (fish bones).

Symptoms, Ailments & Signs

Symptoms of retropharyngeal abscess include fever, swollen lymph nodes in the neck, and difficulty swallowing. The voice sounds muffled and hoarse and there is excessive salivation in the mouth (outright drooling). Patients often complain of a stiff neck and holding their head at a certain angle.

Difficulty breathing may occur if the abscess blocks the windpipe. This is most often heard as a loud whistling sound, especially when inhaling. In order to relieve the pressure from the trachea, the patient preferably lies on their back, with their chin raised and their head tilted towards the neck. Furthermore, severe throat pain and muscle cramps in the rib region when breathing are often reported.

Diagnosis & course of disease

As soon as such symptoms appear, you should consult a doctor. He will first examine your throat and check your breathing. Doctors may be able to feel or even see swelling in a superficial retropharyngeal abscess when examining the neck. This depends on how severe the abscess is.

If the doctor feels a swelling in the neck area, he can differentiate whether it is an accumulation of pus or not. It is a collection of pus if the abscess can be moved in a wavy manner. This is referred to as so-called fluctuation. However, if the abscess is deeper, it can be difficult or impossible to feel. In most cases, however, the back wall of the throat is visibly swollen.

If the doctor cannot see anything, an ultrasound examination or magnetic resonance imaging should be carried out. Both of these procedures are helpful in visualizing a collection of pus. In rare cases, an X-ray or computed tomography can also be performed. However, these procedures are rarely used because they have to be carried out under increased radiation exposure. In addition, a complete blood count should be drawn up and a throat swab should be taken.


This disease causes different symptoms, all of which can have a very negative effect on the quality of life of those affected. In most cases, the patients suffer from a strong fever and also from swollen lymph nodes in the neck.

When swallowing, it comes to swallowing difficulties, so that the intake of food and liquids is associated with pain. As a result, many patients can experience weight loss or even dehydration. There is also an overproduction of saliva in the mouth, causing the patient to drool.

There is also pain in the head or neck, with the neck itself appearing stiff. Due to the blockage of the trachea, those affected can also experience breathing difficulties and, in the worst case, suffocate. Cramps and pain in the muscles also occur with this disease and make everyday life difficult for those affected.

The disease can usually be treated with surgery. Other infections are treated with antibiotics, which usually do not lead to complications. The life expectancy of the patient is not reduced or otherwise restricted if the treatment is successful.

When should you go to the doctor?

A retropharyngeal abscess should always be evaluated and treated by a doctor. As a rule, this disease does not heal itself, so that treatment by a doctor is essential. In some cases, surgery is also necessary to relieve the symptoms of the retropharyngeal abscess.

A doctor should be consulted if the person concerned suffers from severely swollen lymph nodes in the neck. There is also a fever and the general symptoms and symptoms of a cold. Excessive saliva is produced in the mouth, causing the affected person to swallow more frequently. Retropharyngeal abscess can also present with a very stiff neck. Cramps in the muscles are also often a sign of the disease and should be treated by a doctor. First and foremost, a general practitioner can be consulted for a retropharyngeal abscess. However, a visit to a specialist is necessary for further treatment.

Treatment & Therapy

Often the patient recovers quickly with prompt treatment, even if the retropharyngeal abscess had to be drained surgically. After the procedure, the patient is given antibiotics intravenously. Therapy with antibiotics without surgical intervention is often not sufficient. During the procedure, the attending physician inserts a plastic tube through the mouth into the trachea for breathing.

This keeps the airway open and allows the doctor to open the abscess to drain the pus buildup. You should not wait long before opening the abscess, as it can be dangerous if the collection of pus gets a connection to the blood vessel in the neck. If this is the case, serious complications such as blood poisoning or a life-threatening brain abscess can occur.

Furthermore, the abscess cavity behind the pharynx can descend into the thoracic cavity or pass over to a cervical vertebra. These possible complications therefore make timely therapy unavoidable, as this can otherwise have life-threatening consequences. The abscess is classified as a serious condition that requires an inpatient stay in the hospital. If the clinical picture is treated correctly and well, the prognosis is good in most cases.


Such an abscess can be prevented by early detection and adequate treatment of bacterial infections of the respiratory tract.


After treating a retropharyngeal abscess, it is important to prevent the abscess from forming again and allowing bacteria to enter the body. Since some of the bacteria involved in the development of a retropharyngeal abscess can enter the body through the skin, intensive skin and body hygiene should be observed. Adults should shower every day. Children should be bathed daily.

In addition, regular hand disinfection is necessary, especially for children, to prevent the pathogens from multiplying again. Since younger children in particular often get their hands dirty in everyday life, children should not only be disinfected after going to the toilet, but also after playing and at regular intervals throughout the day. In addition, checking the inflammation levels in the blood can help to detect a renewed infection at an early stage.

These check-ups should be discussed with and carried out by the general practitioner or pediatrician in charge. If new, painful, red and/or hot swellings are discovered on the skin, a doctor should be consulted immediately, as this may be an abscess in the subcutaneous tissue. In addition, regular examinations of the neck and throat are necessary, regardless of whether the retropharyngeal abscess was surgically removed, in order to detect a recurrence of a retropharyngeal abscess in good time.

You can do that yourself

First of all, those affected must strictly follow the instructions of the doctor treating them and take the prescribed antibiotic therapy conscientiously. Otherwise, due to its location, a focus of inflammation in the retropharyngeal space can easily spread to the chest cavity and spread to organs such as the heart, esophagus, trachea and large blood vessels. This life-threatening development can only be prevented by consistent therapy. Stopping the antibiotic prematurely can lead to a relapse, in which case the pathogens may have already developed immunity to the therapeutic agent used.

The tendency to abscesses can be significantly reduced by a strengthened immune system. Regular sport, exercise in the fresh air and a balanced diet contribute significantly to this. The therapy of existing diseases until they are completely healed is also an important aspect. In this way, those affected can avoid spreading the infection to other organ systems and thus significantly reduce the risk of secondary diseases.

Patients in whom a retropharyngeal abscess has been diagnosed and removed must in future take a sore throat, swollen tonsils, swollen lymph nodes and other signs of inflammation seriously and have them checked out by a doctor. In most cases, these will be harmless, easily treatable infections. Nevertheless, there is of course the possibility that an abscess has developed again, which should be treated as early as possible.

Retropharyngeal Abscess