Adult retropharyngeal abscess

A 60-year-old man was referred to our hospital after complaining of throat pain for several days. He described the condition as a cold with sore throat. A physical examination revealed swelling of the posterior wall of the oropharynx. Sagittal computed tomography revealed a 3 × 1 cm abscess with ring enhancement in the retropharyngeal space (Fig. 1). Therefore, he was diagnosed with a retropharyngeal abscess [1]. Intraoral surgical drainage was performed under local anesthesia. Antimicrobials (meropenem hydrate) and corticosteroids were administered, and his symptoms disappeared 5 days later. On bacteriological examination, Prevotella corporis (anaerobic bacteria) was identified in the abscess.

Fig. 1.

CT scan of the neck (sagittal view).

CT of the neck revealed a 3 × 1 cm abscess with ringed enhancement in the retropharyngeal space (triangle arrows).

The presence of a retropharyngeal abscess in an adult without any history of trauma or coexistent illness is unusual [2]. An infection of the retropharyngeal space can pass behind the esophagus into the mediastinum [3], [4]. Therefore, “common cold accompanied with sore throat” may actually be a potentially life-threatening deep neck infection.