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Retropharyngeal abscess: recent trends
H S Sharma1, D N Kurl, M Hamzah
1Department of Otorhinolaryngology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan. sharma@kb.usm.my
Insights
Retropharyngeal abscess (RPA) is increasingly affecting older children and adults, often linked to upper respiratory tract infections. Microbiology reveals common bacterial culprits, necessitating updated treatment strategies for this rare but serious condition.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Pediatric Medicine
Background:
- Retropharyngeal abscess (RPA) is a rare deep neck infection.
- Historically prevalent in young children, recent trends suggest a shift in demographics.
Purpose of the Study:
- To analyze the changing clinical trends and microbiology of retropharyngeal abscess.
- To evaluate predisposing factors, causative organisms, and treatment outcomes over a decade.
Main Methods:
- Retrospective review of 17 retropharyngeal abscess cases treated over 10 years.
- Analysis of patient demographics, clinical presentations, predisposing factors, and microbiological data.
Main Results:
- A demographic shift was observed, with 58% of cases in older children and adults, compared to 41% in children under 6.
- Upper respiratory tract infection (URTI) was the most common predisposing factor (52%).
- Other factors included sepsis in younger children and foreign body trauma in older patients. Common pathogens were Klebsiella, Staphylococcus, and Streptococcus.
Conclusions:
- Retropharyngeal abscess epidemiology is evolving, with increased incidence in older age groups.
- Understanding shifting predisposing factors and microbial patterns is crucial for effective management.
- This study highlights the need for updated diagnostic and therapeutic approaches for RPA.
Abstract:
Retropharyngeal abscess (RPA) is relatively rare today. A study of 17 cases of RPA treated at our hospital in the past 10 years showed a shift in the disease from children below 6 years of age (41%) to older children and adults (58%). Upper respiratory tract infection (URTI) was found to be the commonest (52%) aetiological predisposing factor in all age groups. Other aetiological factors were septicaemia (11%) in children below the age of 6 years and trauma due to foreign body (35%) in the older children and adult age groups. Klebsiella, Staphylococcus and Streptococcus were the commonest species of microorganisms grown from pus. The changing clinical trends, microbiology, choice of antibiotics, usefulness of radiology, and complications of this potentially fatal illness are discussed.