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BMJ Case Reports Jun 2022Peritonsillar abscess is a common presentation of complicated acute tonsillitis. The temporomandibular joint septic arthritis is an uncommon clinical entity while its...
Peritonsillar abscess is a common presentation of complicated acute tonsillitis. The temporomandibular joint septic arthritis is an uncommon clinical entity while its complications are further rare. We present a case of a man in his late 30s who presented with a painful swelling in the left preauricular region along with increasing trismus. A diagnosis of peritonsillar abscess due to septic arthritis was made based on clinical history and examination. Patient recovered fully after antibiotic and abscess drainage. This is the first case report of temporomandibular septic arthritis leading to peritonsillar abscess.
Topics: Arthritis, Infectious; Humans; Male; Peritonsillar Abscess; Temporomandibular Joint; Temporomandibular Joint Disorders; Trismus
PubMed: 35667694
DOI: 10.1136/bcr-2021-247111 -
International Journal of Environmental... Jun 2021Peritonsillar abscess (PTA) is an infectious emergency in the head and neck, and patients with end-stage renal disease (ESRD) have an immunocompromised status. However,...
BACKGROUND
Peritonsillar abscess (PTA) is an infectious emergency in the head and neck, and patients with end-stage renal disease (ESRD) have an immunocompromised status. However, no relevant research has focused on the ESRD-PTA relationship. This study explored PTA in ESRD patients and their prognosis.
METHODS
We identified 157,026 patients diagnosed as having ESRD over January 1997 to December 2013 from Taiwan's National Health Insurance Research Database (NHIRD). Each patient with ESRD (hereafter, patients) was matched with one control without chronic kidney disease (CKD; hereafter, controls) by sex, age, urbanization level, and income. Next, PTA incidence until death or the end of 2013 was compared between the two groups, and the relative risk of PTA was analyzed using a multiple logistic regression model.
RESULTS
The patients had a significantly higher PTA incidence than did the controls (incidence rate ratio: 2.02, 95% confidence interval [CI]: 1.40-2.91, < 0.001). The Kaplan-Meier analysis revealed that the patients had a higher cumulative incidence of PTA than did the controls ( < 0.001). In Cox regression analysis, the patients had nearly twofold higher PTA risk (adjusted hazard ratio [HR]: 1.98, 95% CI: 1.37-2.86, < 0.001). The between-group differences in the PTA-related hospital stay length (8.1 ± 10.3 days in patients and 5.7 ± 4.6 days in controls, = 0.09), consequent deep-neck infection complication (4.2% in patients and 6.3% in controls, = 0.682), and mortality (0.0% in both groups) were nonsignificant. Although ESRD does not predict a poor prognosis of PTA, it is an independent PTA risk factor.
Topics: Cohort Studies; Humans; Incidence; Kidney Failure, Chronic; Peritonsillar Abscess; Retrospective Studies; Risk Factors
PubMed: 34202480
DOI: 10.3390/ijerph18136775 -
Complicated peritonsillar abscess extending into the buccal space: an unusual clinical presentation.British Journal of Hospital Medicine... Jul 2022
Topics: Drainage; Humans; Peritonsillar Abscess; Tomography, X-Ray Computed
PubMed: 35938759
DOI: 10.12968/hmed.2021.0591 -
Clinical Case Reports Sep 2022We present an unusual case of Ludwig's angina secondary to a left tonsillar phlegmon in a previously fit and well 50-year-old woman. This tonsillar phlegmon spread along...
We present an unusual case of Ludwig's angina secondary to a left tonsillar phlegmon in a previously fit and well 50-year-old woman. This tonsillar phlegmon spread along the peritonsillar/parapharyngeal plane to cause a diffuse cellulitis and collection in the submental, sublingual, and submandibular spaces despite empirical intravenous antibiotic therapy.
PubMed: 36172328
DOI: 10.1002/ccr3.6325 -
Cureus Apr 2023Infectious mononucleosis (IM) is caused by Epstein-Barr virus (EBV), and the condition is characterized by sore throat, fever, lymphadenopathy, and atypical...
Infectious mononucleosis (IM) is caused by Epstein-Barr virus (EBV), and the condition is characterized by sore throat, fever, lymphadenopathy, and atypical lymphocytosis. These infections are common in early childhood, with a second peak occurring in late adolescence. EBV is spread by contact with oral secretions. Most cases of IM are self-limited. However, there are associated complications, some of which can be serious and fatal. We report the case of a 20-year-old man with splenic infarction and exuberant peritonsillar abscess secondary to an EBV infection. This case highlights the importance of accurate diagnoses and frequent monitoring in IM patients, given the risk of airway obstruction.
PubMed: 37182037
DOI: 10.7759/cureus.37414 -
Journal of Infection in Developing... May 2020This study aims at defining through a retrospective evaluation, the clinical parameters affecting the clinical course and consequently the management of patients...
INTRODUCTION
This study aims at defining through a retrospective evaluation, the clinical parameters affecting the clinical course and consequently the management of patients presenting with cervicofacial abscesses.
METHODOLOGY
A total of 394 patients diagnosed with abscess at the University of Sassari Otorhinolaryngology Division between 2009 and 2017 were included; among these, eleven patients were diagnosed with necrotizing fasciitis. Personal and clinical parameters including the LRINEC score and the medical and/or surgical treatment used were analyzed for each patient. The most frequently affected site was the peritonsillar space (76.9%), followed by the parapharyngeal space.
RESULTS
Mean age was 41(±17) years, the male population was slightly overrepresented (68%). An average of 6 (±7) days of hospitalization duration was recorded. The mortality rate was confirmed to be relatively low (1/349 patients) and was reported only in one patient diagnosed with necrotizing fasciitis (1/11).
CONCLUSION
Diagnosis, correct clinical definition and early medical-surgical treatment of neck abscesses were crucial to reduce complications; LRNEC score, C-reactive protein, glycemia and creatininemia proved to be reliable prognostic indicators of difficult patient management and risk of complications.
Topics: Abscess; Adult; Disease Management; Face; Fasciitis, Necrotizing; Female; Hospitalization; Humans; Male; Middle Aged; Neck; Retrospective Studies; Risk Factors; Young Adult
PubMed: 32525840
DOI: 10.3855/jidc.12191 -
Cureus Jan 2024Intratonsillar abscess (ITA) is rarely reported. Here, we present an uncommon case of acute ITA in an adult, discuss the evaluation and treatment plan, and review the...
Intratonsillar abscess (ITA) is rarely reported. Here, we present an uncommon case of acute ITA in an adult, discuss the evaluation and treatment plan, and review the ITA literature. The abscess reported in the present study was diagnosed through a combination of clinical findings and computed tomography imaging, and treatment included drainage, intravenous (IV) clindamycin, and IV dexamethasone. The literature reports 72 ITA cases with specified treatments: 21 (29.2%) in adults, 19 (26.4%) in children, and 32 (44.4%) in patients of unspecified ages. Among them, 25 (34.7%) responded to antibiotics alone, 11 (15.3%) to needle aspiration and antibiotics, and 36 (50.0%) needed further intervention. Based on the presented case and literature review, we suggest the use of IV antibiotics with needle aspiration as the primary treatment for acute ITA. Incision and drainage (I&D) with antibiotics should be reserved for cases unresponsive to initial measures, and tonsillectomy is recommended for recurrent post-I&D cases.
PubMed: 38313933
DOI: 10.7759/cureus.51657 -
IDCases 2024Helicobacter cinaedi, a gram-negative spiral bacterium, has historically been associated with infections primarily in immunocompromised patients. Recently, however, its...
Helicobacter cinaedi, a gram-negative spiral bacterium, has historically been associated with infections primarily in immunocompromised patients. Recently, however, its potential to cause infections in immunocompetent individuals has been recognized. We report a unique case of a man in his 20 s who reported having sex with men. He presented with symptoms of fever and throat discomfort and was diagnosed with a peritonsillar abscess. While the rapid antigen test for Group A Streptococcus was positive and antibiotics were administered, a puncture fluid from the peritonsillar abscess taken the day after antibiotic treatment revealed the presence of Group C Streptococcus. By the fifth day, the blood culture taken on the first day detected a gram-negative spirochete, which was subsequently identified H. cinaedi. The patient had engaged in oral sex with his male partner, suggesting a potential transmission route. This is significant as H. cinaedi was initially identified from rectal cultures in men who have sex with men (MSM), raising the possibility of pharyngeal transmission through oral sex. In our patient, although H. cinaedi was not isolated from the aspirate of the peritonsillar abscess, its presence in the blood culture and lack of other potential sources of bacteremia make the abscess a likely primary site of infection. This case highlights the importance of considering H. cinaedi as a potential pathogen in immunocompetent patients, particularly in cases of MSM. The potential for H. cinaedi transmission through oral sex and its role in the development of peritonsillar abscesses, a previously unreported association, requires further investigation.
PubMed: 38721054
DOI: 10.1016/j.idcr.2024.e01975 -
European Archives of... Jan 2023Several theories have been proposed regarding the origin of lateral neck cysts (LNC). Besides complete surgical resection ipsilateral tonsillectomy and dissection of a...
PURPOSE
Several theories have been proposed regarding the origin of lateral neck cysts (LNC). Besides complete surgical resection ipsilateral tonsillectomy and dissection of a tract or its remnants is sometimes recommended. In this retrospective trial we wanted to evaluate if patients, who received LNC resection only, develop complications or recurrence to justify this surgical strategy.
METHODS
Patients who received LNC resection between 2004 and 2017 at the Ear Nose and Throat Department of a university hospital were included. Data was collected from the clinic database and through a structured telephone interview.
RESULTS
A total of 126 patients met the inclusion criteria. In this collective, the diagnosis of a lateral neck cyst was confirmed histologically. Mean age at time of operation was 38 years (± 14.6). The median follow-up time was 7 years (range 3-18). None of the participants experienced recurrent unilateral pharyngitis or tonsillitis during follow-up. Furthermore, there was no case of postoperative peritonsillar, neck phlegmon or neck abscess. No patient reported recurrence of LNC.
CONCLUSIONS
Sole complete resection of LNCs is sufficient to avoid postoperative infections and recurrences. Therefore, ipsilateral tonsillectomy and tract dissection is not necessary in routine cases of LNC surgery.
Topics: Humans; Adult; Tonsillectomy; Retrospective Studies; Tonsillitis; Pharyngitis; Cysts; Peritonsillar Abscess; Recurrence
PubMed: 35852652
DOI: 10.1007/s00405-022-07542-0 -
The European Journal of General Practice Dec 2022Acute upper respiratory infections are the most common reason for primary physician visits in the community. This study investigated whether the type of antibiotic used...
BACKGROUND
Acute upper respiratory infections are the most common reason for primary physician visits in the community. This study investigated whether the type of antibiotic used to treat streptococcal tonsillitis can reduce the burden by affecting the number of additional visits.
OBJECTIVES
To assess the effect of different antibiotic treatments for tonsillitis on the number of additional primary physician visits and the development of infectious or inflammatory sequels.
METHODS
This retrospective study included first cases of culture-confirmed streptococcal tonsillitis ( = 242,366, 55.3% females, 57.6% aged 3-15 years) treated in primary clinics throughout Israel between the years 2010 and 2019. Primary outcomes were the number of additional primary physician visits, due to any cause or due to specific upper airway infections. Secondary outcomes were the number of developed complications, such as peritonsillar abscess, post-streptococcal glomerulonephritis, rheumatic fever, post-streptococcal arthritis, chorea and death.
RESULTS
Compared to penicillin-V, adjusted incidence rate ratios (IRR) for additional primary physician visits at 30-days were highest for IM benzathine-benzylpenicillin (IRR = 1.46, CI 1.33-1.60, < .001) and cephalosporin treatment (IRR = 1.27, CI 1.24-1.30, < .001). Similar results were noted for visits due to specific diagnoses such as recurrent tonsillitis, otitis media and unspecified upper respiratory tract infection. Amoxicillin showed decreased adjusted odds ratio (aOR) of developing complications (aOR = 0.68, CI 0.52-0.89, < .01 for any complication. aOR = 0.75, CI 0.55-1.02, = .07 for peritonsillar or retropharyngeal abscess).
CONCLUSION
Penicillin-V treatment is associated with fewer additional primary physician visits compared to other antibiotic treatments. Amoxicillin and penicillin-V are associated with fewer complications. These findings are limited by the retrospective nature of the study and lack of adjustment for illness severity. Further prospective studies may be warranted to validate results.
Topics: Amoxicillin; Anti-Bacterial Agents; Female; Humans; Male; Peritonsillar Abscess; Pharyngitis; Prospective Studies; Respiratory Tract Infections; Retrospective Studies; Tonsillitis; Treatment Outcome
PubMed: 35695024
DOI: 10.1080/13814788.2022.2083105