Clinical Problem Solving: Radiology
May 18, 2009

Radiology Quiz Case 1: Diagnosis

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Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2009

Arch Otolaryngol Head Neck Surg. 2009;135(5):516-519. doi:10.1001/archoto.2009.34-b

Retropharyngeal abscess may develop after acute bacterial pharyngitis or other pyogenic infections in the head and neck region. These disorders can cause inflammation of the lymph nodes in the retropharyngeal space, a condition that occurs more commonly in children than in adults. In contrast, retropharyngeal abscess in adults develops as a result of vertebral pyogenic osteomyelitis, tuberculosis of the spine, or external injuries caused by endoscopes or foreign bodies (eg, fish bones).13Patients with diabetes mellitus or those who are receiving prolonged steroid therapy are predisposed to retropharyngeal abscess.3The retropharyngeal space is situated between the prevertebral fascia and the buccopharyngeal fascia. It contains loose areolar tissue and a group of lymph nodes.4Tuberculosis of the retropharyngeal space is one of the rare forms of extrapulmonary tuberculosis. A study of 117 patients with head and neck tuberculosis showed only 1 case of retropharyngeal abscess.5

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