Is a retropharyngeal abscess caused by Streptococcus (strep) contagious?

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From the Guidelines

A retropharyngeal abscess caused by strep throat is not directly contagious, but the underlying streptococcal infection that led to the abscess can be transmitted to others. The abscess itself is a collection of pus deep in the tissues of the neck that forms as a complication of a streptococcal infection, typically after the bacteria has spread from the throat or tonsils to the retropharyngeal space. While you cannot "catch" the abscess directly from someone, the strep bacteria causing the initial infection can spread through respiratory droplets when an infected person coughs, sneezes, or talks 1.

According to the clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis, accurate diagnosis of streptococcal pharyngitis followed by appropriate antimicrobial therapy is important for the prevention of acute rheumatic fever and suppurative complications, such as peritonsillar abscess, cervical lymphadenitis, mastoiditis, and possibly other invasive infections 1. The guideline also emphasizes the importance of completing the full course of antibiotics prescribed by the doctor, which typically includes high-dose intravenous antibiotics like ampicillin-sulbactam, clindamycin, or a combination of drugs depending on the severity 1.

To prevent spreading the underlying strep infection to others, it is essential to maintain good hand hygiene, avoid sharing personal items, cover your mouth when coughing or sneezing, and follow your doctor's advice about when it's safe to return to work or school, usually after 24-48 hours of antibiotic treatment when you're no longer considered contagious 1.

Some key points to consider:

  • The strep bacteria can spread through respiratory droplets when an infected person coughs, sneezes, or talks 1.
  • Completing the full course of antibiotics prescribed by the doctor is crucial to prevent the spread of the infection and reduce the risk of complications 1.
  • Maintaining good hand hygiene, avoiding sharing personal items, and covering your mouth when coughing or sneezing can help prevent the spread of the infection 1.
  • The abscess itself is not directly contagious, but the underlying streptococcal infection can be transmitted to others 1.

It is essential to note that the evidence from the clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis supports the importance of accurate diagnosis and appropriate antimicrobial therapy to prevent complications and reduce the spread of the infection 1.

From the Research

Contagiousness of Retropharyngeal Abscess from Strep

  • The contagiousness of retropharyngeal abscess from strep is not directly addressed in the provided studies.
  • However, it is known that group A beta-hemolytic streptococcal pharyngitis, which can lead to retropharyngeal abscess, is contagious 2.
  • The study on streptococcal pharyngitis mentions that it is a common infection responsible for more than 6 million office visits in the United States annually, implying that it can be spread from person to person 2.
  • Another study on retropharyngeal abscess in adults found that group A beta-hemolytic streptococci were identified in three out of four cases, suggesting a possible link between strep throat and retropharyngeal abscess 3.
  • However, the contagiousness of retropharyngeal abscess itself is not explicitly stated in the provided studies.

Transmission and Prevention

  • The transmission of group A beta-hemolytic streptococcal pharyngitis, which can lead to retropharyngeal abscess, can be prevented by avoiding close contact with infected individuals, practicing good hygiene, and using antibiotics as prescribed 2.
  • It is essential to note that retropharyngeal abscess is a serious condition that requires prompt diagnosis and treatment to prevent complications 4, 3, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Streptococcal Pharyngitis: Rapid Evidence Review.

American family physician, 2024

Research

Retropharyngeal abscess in adults.

Revue de laryngologie - otologie - rhinologie, 2012

Research

Retropharyngeal Abscess. Clinical Review of Twenty-five Years.

Acta otorrinolaringologica espanola, 2021

Research

Retropharyngeal abscess: diagnosis and treatment update.

Infectious disorders drug targets, 2012

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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