What is the role of lab tests in the workup of retropharyngeal abscess (RPA)?

Updated: Jan 08, 2021
  • Author: Joseph H Kahn, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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See the list below:

  • Complete blood count

    • The mean white blood cell (WBC) count in one study was 17,000, with a range of 3100-45,900.

    • WBC counts in 18% of the patients were less than 8000; thus, a normal WBC count does not rule out the diagnosis of retropharyngeal abscess.

    • In a study in Germany, the mean WBC (±standard deviation was 14,700 [±10,500]), with a range from 200-114,000.

  • Blood cultures are indicated before administration of intravenous antibiotics, but culture results may be negative in as many as 82% of retropharyngeal abscess cases.

  • A culture of pus, aspirated at the time of surgical drainage of the retropharyngeal abscess, can grow one or more organisms 91% of the time.

  • C-reactive protein

    • In one study of adults and children with deep cervical space infections, patients with C-reactive protein level greater than 100 had longer hospital stays.

    • In a German study, mean (±standard deviation) C-reactive protein level was 15.7 (±12.9), with a range from 0.0-74.

    • A study in Taiwan reveals that deep neck infection patients with C-reactive protein values greater than 100 tend to develop complications and have prolonged hospitalizations. [50]

  • Erythrocyte sedimentation rate [5]

  • COVID-19 testing - In adult or pediatric patients who present with a sore throat [6]

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