Retropharyngeal abscess

Description:

Retropharyngeal (retropharyngeal) abscess  - accumulation of pus between neck tissues in retropharyngeal space, is shown by symptoms of a pharyngalgia, fever, a stiff neck and other general infectious symptoms. This disease meets considerably today less than last century, because of broad use of the antibiotics used for treatment of purulent upper respiratory tract infections. Retropharyngeal abscess, earlier almost always shown only at children, is now observed in increasing frequency at adults. Retrofaringialny abscess in the diagnostic plan represents a problem as doctors not often face it, and its symptoms are changeable occasionally.

Early diagnosis and aggressive conducting treatment of retropharyngeal abscesses as all of them still promote considerable incidence and mortality is very important.

Symptoms of Retropharyngeal abscess:

Display of a disease variable, also depends on an age group. Symptoms of retropharyngeal abscesses are various for adults, children and babies (children till 1 year).
Symptoms at adults:

    * pharyngalgia
    * fervescence
    * swallowing disturbance (dysphagy)
    * morbidity at reception of food (odinofagiya)
    * neck pain
    * it is difficult for patient to breathe

Patients with retropharyngeal abscess can feel signs of obstruction of respiratory tracts, but often does without it. Persons who do not show signs of obstruction of respiratory tracts first can feel them in later stages of a disease. The most widespread signs  are differently shown at adults and children.
Objective signs at adults

    * hypostasis of a back wall of a throat (37%)
    * stiff neck
    * neck hyperadenosis    
    *  fervescence
    * hypersalivation
    * stridor (squeezing of upper respiratory tracts)

Objective signs at babies and children

    * neck hyperadenosis (36%)
    * retropharyngeal  tumor  (55%; not to palpate at children)
    * fever (64%)
    * stridor (3%)
    * wryneck (18%)
    * stiff neck (64%)
    * hypersalivation (22%)
    * nervousness (43%)
    * hardening of tissues of neck (55%)
    * drowsiness (42%)
    * breath disturbances (4%)
    * the disturbances connected with tonsillitis, a peritonsillitis, pharyngitis, and average otitis.

Symptoms at children are more senior than 1 year:

    * Pharyngalgia (84%)
    * fervescence (64%)
    * stiff neck (64%)
    * morbidity at reception of food (odinofagiya) (55%)

    * cough
          o fervescence (85%)
          o hardening of tissues of neck (97%)
          o difficulty of passing of food across the food canal (55%)
          allocation o from a nose (55%)
          o drowsiness (38%)
          o cough (33%)

Reasons of Retropharyngeal abscess:

Retropharyngeal abscess most often arises at Europeans, is more rare at Asians, sometimes affects representatives of Afro-American race. Among boys and men incidence is higher, than among girls and women, but is insignificant. As for age, initially retropharyngeal abscess was considered as exclusively children's disease, but now even more often occurs at adults.
Retropharyngeal abscess develops for the second time after spread of an infection on lymphatic ways or turns out to be consequence  of a respiratory or food infection. Injuries of tissues of throat after an intubation of a trachea, installation of a nazogastralny tube, endoscopy of a duodenum, hit of foreign bodys, can lead external damages to development of retropharyngeal abscess. Patients, with the weakened immunity or chronic diseases, for example persons with a diabetes mellitus, cancer patients, alcoholism or AIDS, are exposed to the increased risk of development of retropharyngeal abscess.

Most often the causative agent of retropharyngeal abscesses are aerobes and anaerobe bacterias, but also gram-negative organisms can also cause this disease. Quite often at bacteriological crops find the mixed flora.
Microorganisms most of which often find at retropharyngeal abscesses:

    * beta and hemolitic streptococcus
    * golden streptococcus
    * metitsilin-resistant golden staphylococcus
    * klebsiyela
    * bacteroids
    * epidermal staphylococcus
    * anaerobic staphylococcus
    * colibacillus
    * tuberculosis mycobacterium

Treatment of Retropharyngeal abscess:

The patient with retropharyngeal abscess is urgently taken to hospital for inspection and treatment the ENT SPECIALIST by the doctor (otolaryngologist).

If there are signs of squeezing of upper respiratory tracts and breath is complicated, then the intubation (introduction of a respiratory tube) is prohibited, the surgical or trubchasto-catheter cricotomy (resuming of breath by means of creation of an opening in a throat cartilage is made from the front surface of a neck).  To the patient allow to breathe the air oxygenated.

Opening of retropharyngeal abscess and drainage of an abscess is carried out. Further high doses of antibiotics register, begin with amoxicillin and erythromycin, further change according to an antibiotikogramma.  It is impossible to self-medicate, put away for later the moment of the address to the doctor at all – under the threat your health and life!