Retropharyngeal abscess (RPA) is an abscess located in the tissues in the back of the throat behind the posterior pharyngeal wall (the retropharyngeal space). Because RPAs typically occur in deep tissue, they are difficult to diagnose by physical examination alone. RPA is a relatively uncommon illness, and therefore may not receive early diagnosis in children presenting with stiff neck, malaise, difficulty swallowing, or other symptoms listed below. Early diagnosis is key, while a delay in diagnosis and treatment may lead to death. Parapharyngeal space communicates with retropharyngeal space and an infection of retropharyngeal space can pass down behind the esophagus into the mediastinum. RPAs can also occur in adults of any age. RPA can lead to airway obstruction or sepsis – both life-threatening emergencies. Fatalities normally occur from patients not receiving treatment immediately and suffocating prior to knowing that anything serious was wrong. Signs and symptoms
Signs and symptoms may include the following stiff neck (limited neck mobility or torticollis), some form of palpable neck pain (may be in "front of the neck" or around the Adams Apple), malaise, difficulty swallowing, fever, stridor, drooling, croup-like cough or enlarged cervical lymph nodes. Any combination of these symptoms should arouse suspicion of RPA. Causes
RPA is usually caused by a bacterial infection originating from the nasopharynx, tonsils, sinuses, adenoids, molar teeth or middle ear. Any upper respiratory infection (URI) can be a cause. RPA can also result from a direct infection due to penetrating injury or a foreign body.
Relation to true melanoses
The condition is unrelated to true melanoses, such as Peutz–Jeghers syndrome and smokers melanosis.Peutz–Jeghers syndrome causes pigmentation of the skin and mucous surfaces with melanin, and polyps in the digestive tract. Non-colonic pseudomelanoses
Pseudomelanoses of other parts of the gastrointestinal tract have also been reported, and are of unclear relevance.Patients with colostomies can have melanosis involving the stoma, which is also of no significance. References


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