A parapharyngeal abscess is a collection of infected tissue deep in the neck, often caused by bacterial infections of the tonsils or pharynx. Symptoms include sore throat, difficulty swallowing, and swelling in the neck. Treatment includes antibiotics and surgical drainage for large abscesses.
A parapharyngeal abscess is a collection of infected, swollen, inflamed tissue deep inside the neck. Abscesses provide a space for bacteria to thrive and potentially spread to nearby blood vessels and lymph nodes. In most cases, these abscesses occur as a result of a serious infection of the tonsils, throat, or respiratory tract. Treatment in the form of oral antibiotics is usually enough to cure small abscesses before they cause complications. Large pus-filled cysts may need to be surgically drained to prevent airway obstruction and infection throughout the body.
The parapharyngeal space is an empty triangular space located between the pharynx, carotid artery, internal jugular vein, and several small muscles in the neck. Most abscesses in the parapharyngeal space are preceded by bacterial infections of the tonsils or pharynx. Pathogens spread through the broken and irritated tissue and form cysts in the area. Many different types of bacteria can cause abscesses to develop, including the common strains of strep and staph.
A person of any age can develop a parapharyngeal abscess, although the problem is more common in children and adolescents. Adults who have weakened immune systems are also at a higher risk. The early symptoms of a parapharyngeal abscess are similar to those of common throat infections, including sore throat, difficulty swallowing, low-grade fever, and fatigue. A growing abscess can cause significant swelling in the neck and significant airway obstruction. If the carotid artery or jugular vein is involved, a person can have very high fever, mental confusion, and dangerous internal bleeding.
It is important for parents to contact a pediatrician when their child is showing possible symptoms of a parapharyngeal abscess. A doctor may inspect your throat and tonsils to look for signs of infection. Computed tomography is useful for visualizing the parapharyngeal space and looking for abnormal swellings. After confirming the diagnosis, blood and mucus samples may be collected to check for the specific bacteria involved.
When a parapharyngeal abscess is detected early, it can usually be treated with a four to six week course of oral antibiotics. A doctor may decide to drain a growing abscess using a needle that is inserted through the mouth or through a small cut made in the front of the neck. If there is airway constriction, a patient may need to be admitted to the hospital so that specialists can provide oxygen and surgically open the pharynx. A cyst may need to be removed with a scalpel if it is likely to rupture and spread bacteria to blood vessels.
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