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Annals of Clinical Microbiology and... Jul 2020The vast majority of patients with peritonsillar abscess (PTA) recover uneventfully on abscess drainage and antibiotic therapy. However, occasionally patient´s... (Review)
Review
BACKGROUND
The vast majority of patients with peritonsillar abscess (PTA) recover uneventfully on abscess drainage and antibiotic therapy. However, occasionally patient´s condition deteriorates as the infection spread in the upper airway mucosa, through cervical tissues, or hematogenously. The bacterial etiology of PTA is unclarified and the preferred antimicrobial regimen remains controversial. The current narrative review was carried out with an aim to (1) describe the spectrum of complications previously recognized in patients with peritonsillar abscess (PTA), (2) describe the bacterial findings in PTA-associated complications, and (3) describe the time relation between PTA and complications.
METHODS
Systematic searches in the Medline and EMBASE databases were conducted and data on cases with PTA and one or more complications were elicited.
RESULTS
Seventeen different complications of PTA were reported. The most frequently described complications were descending mediastinitis (n = 113), para- and retropharyngeal abscess (n = 96), necrotizing fasciitis (n = 38), and Lemierre´s syndrome (n = 35). Males constituted 70% of cases and 49% of patients were > 40 years of age. The overall mortality rate was 10%. The most prevalent bacteria were viridans group streptococci (n = 41, 25%), beta-hemolytic streptococci (n = 32, 20%), F. necrophorum (n = 21, 13%), S. aureus (n = 18, 11%), Prevotella species (n = 17, 10%), and Bacteroides species (n = 14, 9%). Simultaneous diagnosis of PTA and complication was more common (59%) than development of complication after PTA treatment (36%) or recognition of complication prior to PTA (6%).
CONCLUSION
Clinicians involved in the management of PTA patients should be aware of the wide range of complications, which may arise in association with PTA development. Especially males and patients > 40 years of age seem to be at an increased risk of complicated disease. In addition to Group A streptococci and F. necrophorum, the current findings suggest that viridans group streptococci, S. aureus, Prevotella, and Bacteroides may also play occasional roles in the development of PTA as well as spread of infection. Complications occasionally develop in PTA patients, who are treated with antibiotics and surgical drainage.
Topics: Airway Obstruction; Anti-Bacterial Agents; Bacterial Infections; Drainage; Humans; Peritonsillar Abscess
PubMed: 32731900
DOI: 10.1186/s12941-020-00375-x -
Anesthesiology Clinics Jun 2015Infectious and inflammatory conditions of the head and neck may present with impaired airways. An understanding of the pathophysiology will allow for accurate diagnosis... (Review)
Review
Infectious and inflammatory conditions of the head and neck may present with impaired airways. An understanding of the pathophysiology will allow for accurate diagnosis and prompt intervention. Preintervention discussion and planning by members of the airway team are crucial in developing a primary and backup plans for safely securing the airway.
Topics: Angioedema; Bacterial Infections; Edema; Humans; Ludwig's Angina; Peritonsillar Abscess; Respiratory Tract Infections; Retropharyngeal Abscess; Supraglottitis
PubMed: 25999006
DOI: 10.1016/j.anclin.2015.02.005 -
The Journal of Laryngology and Otology Jan 2023The junior otolaryngologist is responsible for recognition and drainage of the peritonsillar abscess. Although other simulators have been proposed, there is still a need...
BACKGROUND
The junior otolaryngologist is responsible for recognition and drainage of the peritonsillar abscess. Although other simulators have been proposed, there is still a need for an accessible, educationally useful, low-cost peritonsillar abscess simulator to build skills and confidence in the novice.
METHODS
The peritonsillar abscess simulator was constructed from basic disposable healthcare equipment and a party balloon. Evaluation of this Newport Quinsy Simulator was performed by expert and novice clinicians, who provided feedback in the form of Likert scales and free-text qualitative responses.
RESULTS
Overall, 24 clinicians evaluated the simulator. All felt the simulator was useful for the novice otolaryngologist, and represented the key anatomy and motor skills needed to drain a peritonsillar abscess. Qualitative evaluation highlighted the educational usefulness of the simulator as a peritonsillar abscess training device.
CONCLUSION
The Newport Quinsy Simulator is affordable, accessible, easy to use and educationally valuable to the novice otolaryngologist.
Topics: Humans; Peritonsillar Abscess; Drainage; Costs and Cost Analysis
PubMed: 35678386
DOI: 10.1017/S0022215122001220 -
Ugeskrift For Laeger Jun 2023
Topics: Humans; Peritonsillar Abscess; Emergency Service, Hospital; Ultrasonography
PubMed: 37325984
DOI: No ID Found -
Laryngo- Rhino- Otologie Jun 2023
Topics: Adult; Humans; Peritonsillar Abscess; Risk Factors
PubMed: 37267960
DOI: 10.1055/a-1988-5655 -
The Journal of Laryngology and Otology Oct 2018
Topics: Humans; Otorhinolaryngologic Diseases; Peritonsillar Abscess; Smoking
PubMed: 30387411
DOI: 10.1017/S0022215118001895 -
AJNR. American Journal of Neuroradiology Feb 2022Previous literature is vague on the prevalence and exact nature of abscesses in tonsillar infections, ranging from intratonsillar and peritonsillar collections to deep...
BACKGROUND AND PURPOSE
Previous literature is vague on the prevalence and exact nature of abscesses in tonsillar infections, ranging from intratonsillar and peritonsillar collections to deep extension involving the parapharyngeal and retropharyngeal spaces. MR imaging has excellent diagnostic accuracy in detecting neck infections and can potentially clarify this issue. We sought to characterize the spectrum of MR imaging findings regarding tonsillar infections.
MATERIALS AND METHODS
We conducted a retrospective cohort study of emergency neck MR imaging scans of patients with tonsillar infections. Imaging data were assessed in terms of signs of infection and the location of abscesses and were compared with clinical findings, final diagnoses, and surgical findings as reference standards.
RESULTS
The study included 132 patients with tonsillar infection. Of these, 110 patients (83%) had ≥1 abscess (99 unilateral, 11 bilateral; average volume, 3.2 mL). Most abscesses were peritonsillar, and we found no evidence of intratonsillar abscess. Imaging showed evidence of parapharyngeal and retropharyngeal extension in 36% and 10% of patients, respectively. MR imaging had a high positive predictive value for both abscesses (0.98) and deep extension (0.86). Patients with large abscesses and widespread edema patterns had a more severe course of illness.
CONCLUSIONS
Emergency neck MR imaging can accurately describe the extent and nature of abscess formation in tonsillar infections.
Topics: Humans; Infections; Magnetic Resonance Imaging; Neck; Peritonsillar Abscess; Retrospective Studies
PubMed: 34916205
DOI: 10.3174/ajnr.A7368 -
Praxis 2020
Topics: Angina Pectoris; Anti-Bacterial Agents; Humans; Peritonsillar Abscess
PubMed: 33292007
DOI: 10.1024/1661-8157/a003572 -
Indian Journal of Otolaryngology and... Dec 2022Peritonsillar abscess is a known complication of tonsillitis. The patient usually presents with typical symptoms of odynophagia, fever and difficulty in mouth opening....
Peritonsillar abscess is a known complication of tonsillitis. The patient usually presents with typical symptoms of odynophagia, fever and difficulty in mouth opening. The diagnosis is established by clinical examination that commonly revealed unilateral peritonsillar swelling. Aspiration of pus will confirm the diagnosis. We report an atypical presentation of peritonsillar abscess case which presented only with loss of taste sensation without dysphagia, fever, odynophagia or trismus.
PubMed: 33718102
DOI: 10.1007/s12070-021-02506-y