RETROPHARYNGEAL ABSCESS - A CLINICAL REVIEW

Retropharyngeal abscesses are uncommon but potentially lethal infectio ns, especially in the paediatric population under the age of five year s. Abscesses in this group are classically secondary to upper respirat ory infections especially oropharyngeal infections, while in the adult group they are usually secondary to trauma, foreign bodies, or as a c omplication of dental infections. Early diagnosis and the wide spread use of antibiotics have made these infections less common today. Betwe en the years 1985-1996, 19 cases of retropharyngeal abscesses were tre ated in our department. Factors such as age, sex, aetiology, presentin g signs, symptoms, methods of diagnosis, treatment and complications w ere reviewed. Thirty-two per cent of the cases were secondary trauma. A lateral neck film showing widening of the prevertebral space was the most important diagnostic tool, computed tomography (CT) scan was use d in 63 per cent of cases to verify the signs of an abscess and to pro vide more accurate anatomical localization. Thirteen cases required su rgical drainage. The single most commonly isolated pathogen was Strept ococcus pyogenes. There were no deaths and only one recurrence requiri ng repeated surgical drainage. One case was complicated by a spinal ca nal abscess. We also report two cases of retropharyngeal abscess in ch ildren caused by swallowing of unusual foreign bodies.