How is a retropharyngeal abscess (RPA) treated?

Updated: Jan 08, 2021
  • Author: Joseph H Kahn, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
  • Print
Answer

ED management of retropharyngeal abscess includes attention to the airway, fluid resuscitation if necessary, antibiotic treatment, and preparation for an emergency operation, if indicated. Frequent vital sign checks and continuous oxygen saturation monitoring are essential.

  • Airway management

    • Apply supplemental oxygen. In young children, this can be completed in a nonthreatening way by letting the parent direct blow-by oxygen at the child's face.

    • Endotracheal intubation may be required if the patient has signs of upper airway obstruction. It may be difficult because of upper airway swelling.

    • Cricothyrotomy (surgical or needle) may be required in the patient with upper airway obstruction who cannot be intubated, but the procedure may be difficult to perform due to tissue edema and distortion.

    • Tracheostomy may be required for definitive airway management, but the procedure may be difficult to perform due to tissue edema and distortion. [9]

    • Airway management in the operating room is preferred, with surgeon and anesthesiologist present, if clinical condition and time allow it. [8]

  • Intravenous fluids are required if the patient is dehydrated because of fever and difficulty swallowing.

  • Antibiotic treatment (see the Medication section)


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!