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Retropharyngeal Abscess

Retropharyngeal Abscess is a topic covered in the 5-Minute Pediatric Consult.

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A relatively rare but potentially life-threatening infection occurring in the potential space between the posterior pharyngeal wall and prevertebral fascia


  • Winter-spring seasonality
  • Children <5 years are at highest risk.
  • 4.1 per 100,000 children <20 years old
  • Male-to-female ratio 2:1


  • Most infections result from pharyngitis or supraglottitis and occur because of suppuration of the retropharyngeal lymph nodes, which lie in two paramedian chains and drain various nasopharyngeal structures and sinuses.
  • These lymph gland chains disappear in childhood; thus, retropharyngeal abscesses are most common in infancy and early childhood.
  • Cellulitis of the retropharyngeal area leads to formation of a phlegmon, which matures into an abscess.
  • Other sources of infection in this space, often seen in older children and adolescents, include penetrating trauma of the posterior pharynx (e.g., foreign object aspiration, dental procedures, attempts at intubation).
  • Extension of infection into this space can arise from vertebral body osteomyelitis or a dental abscess.


  • Infectious: Cultures often reveal multiple organisms.
  • The predominant organisms isolated include the following:
    • Streptococcus (group A and others)
    • Staphylococcus aureus
    • Various anaerobic species (e.g., Bacteroides, Peptostreptococcus, Fusobacterium)
  • Many of the isolates are β-lactamase producers.

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Cabana, Michael D., editor. "Retropharyngeal Abscess." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617239/0.2/Retropharyngeal_Abscess.
Retropharyngeal Abscess. In: Cabana MD, ed. 5-Minute Pediatric Consult. 8th ed. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617239/0.2/Retropharyngeal_Abscess. Accessed June 24, 2019.
Retropharyngeal Abscess. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult. Available from https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617239/0.2/Retropharyngeal_Abscess
Retropharyngeal Abscess [Internet]. In: Cabana MD, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2019 June 24]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617239/0.2/Retropharyngeal_Abscess.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Retropharyngeal Abscess ID - 617239 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617239/0.2/Retropharyngeal_Abscess PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -