Drainage of abscesses and early initiation of appropriate antibiotic coverage is important. Later, the child appears acutely ill with fever, upper airway compromise, stridor, drooling and respiratory distress. Symptoms usually precede the diagnosis by 5-6 days. Pathophysiology Retropharyngeal abscess is a potentially life-threatening upper airway infection in children. The retropharyngeal space contains loose connective tissue and lymph nodes, receiving drainage from adjacent bones and sinuses, teeth, Eustachian tube, middle ear and nasopharynx.
Blood cultures are usually negative.
Abscess cultures usually contain polymicrobes, such as Staphylococcus aureus, streptococcal species, and anaerobes. The lateral neck radiograph will show thickening of the retropharyngeal space with anterior displacement of the airway. Occasionally, gas can be seen in the retropharyngeal soft tissues. Computed tomography better delineates the abnormality, and better demonstrates walled off abscess cavities. Meningitis Peritonsillar abscess Treatment Antibiotic therapy alone is successful in 15-25 percent of cases.