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Journal of Clinical Medicine Apr 2024Odontogenic infection is one of the main etiologies of deep neck infection (DNI). However, the relationship between chronic periodontitis (CP) and the incidence of DNI...
Associations between Peritonsillar Abscess and Deep Neck Infection in Chronic Periodontitis Patients: Two Nested Case-Control Studies Using a National Health Screening Cohort.
Odontogenic infection is one of the main etiologies of deep neck infection (DNI). However, the relationship between chronic periodontitis (CP) and the incidence of DNI has not been examined. This study aimed to evaluate the incidence of DNI and peritonsillar abscess (PTA) after CP. The Korean National Health Insurance Service-National Sample Cohort 2002-2019 was used. In Study I, 4585 PTA patients were matched with 19,340 control I participants. A previous history of CP for 1 year was collected, and the odds ratios (ORs) of CP for PTA were analyzed using conditional logistic regression. In Study II, 46,293 DNI patients and 185,172 control II participants were matched. A previous history of CP for 1 year was collected, and conditional logistic regression was conducted for the ORs of CP for DNI. Secondary analyses were conducted in demographic, socioeconomic, and comorbidity subgroups. In Study I, a history of CP was not related to the incidence of PTA (adjusted OR = 1.28, 95% confidence interval [CI] = 0.91-1.81). In Study II, the incidence of DNI was greater in participants with a history of CP (adjusted OR = 1.55, 95% CI = 1.41-1.71). The relationship between CP history and DNI was greater in groups with young, male, low-income, and rural residents. : A prior history of CP was associated with a high incidence of DNI in the general population of Korea. Patients with CP need to be managed for the potential risk of DNI.
PubMed: 38673440
DOI: 10.3390/jcm13082166 -
Cureus Mar 2024Peritonsillar abscess is an infection of tonsillar soft tissue which can spread into additional neck structures leading to symptoms of fever, sore throat, dysphagia, and...
Peritonsillar abscess is an infection of tonsillar soft tissue which can spread into additional neck structures leading to symptoms of fever, sore throat, dysphagia, and airway compromise. We describe a case of diabetic ketoacidosis in a patient with a history of uncontrolled type II diabetes mellitus admitted for a peritonsillar abscess who received intravenous steroids for management of the abscess swelling. The patient was treated with an insulin drip, hydration, and electrolyte replacement with a resolution to his anion gap and metabolic acidosis. Diabetic ketoacidosis occurs during increased gluconeogenesis leading to ketosis and metabolic acidosis which can be a life-threatening condition if not quickly recognized and treated. This case highlights the importance of monitoring and treating elevated blood glucose in acutely ill patients receiving steroid therapy.
PubMed: 38665732
DOI: 10.7759/cureus.56917 -
Ear, Nose, & Throat Journal Apr 2024Peritonsillar abscesses (PTAs) are typically caused by group A or mixed oral flora. is a part of the normal vaginal microbiome, and overgrowth can cause bacterial...
Peritonsillar abscesses (PTAs) are typically caused by group A or mixed oral flora. is a part of the normal vaginal microbiome, and overgrowth can cause bacterial vaginosis. We present a case of recurrent PTA with superinfection, which occurred after the patient performed oral sex on a female after incision and drainage of her initial PTA. The patient continued to have recurrent PTAs until was identified, and antibiotic coverage was broadened to cover both group A and . This case highlights the importance of culturing PTA aspirate for directed antibiosis in persistent or recurrent infections. The rare superinfection also raises the question of advising abstinence from oral-genital contact after oral procedures to minimize risk of superinfection.
PubMed: 38647231
DOI: 10.1177/01455613241246486 -
Cureus Mar 2024is a gram-negative facultatively anaerobic, capnophilic bacterium typically residing in the human oropharyngeal flora. This opportunistic pathogen can cause a wide...
is a gram-negative facultatively anaerobic, capnophilic bacterium typically residing in the human oropharyngeal flora. This opportunistic pathogen can cause a wide range of infections, from bacteremia to septic abortion. However, it is exceedingly rare for a patient to present with tonsillitis due to . Herein, we discuss the presentation, hospital course, and clinical trajectory of a patient experiencing complications of tonsillitis related to in the context of acute myeloid leukemia. Additionally, we delve into the treatment approaches and challenges in managing this particular pathogen.
PubMed: 38646309
DOI: 10.7759/cureus.56551 -
European Annals of Otorhinolaryngology,... Apr 2024Peritonsillar abscess (PTA) is a frequent pathology. Treatment consists in drainage of the collection, associated to probabilistic antibiotic therapy. The usefulness of...
PURPOSE
Peritonsillar abscess (PTA) is a frequent pathology. Treatment consists in drainage of the collection, associated to probabilistic antibiotic therapy. The usefulness of cytobacteriological testing (CBT) of the drainage pus is controversial.
MATERIAL AND METHODS
A retrospective study of patients managed for PTA between 2013 and 2020 in our university hospital was performed. The main objective was to assess the usefulness of CBT in the management of PTA. The secondary objectives were to determine the bacteriological profile involved in the onset of PTA and to assess the rate of bacterial resistance to antibiotics prescribed on a probabilistic basis.
RESULTS
The study included 207 patients: 70 outpatients (33%) and 137 inpatients (67%). Probabilistic antibiotic therapy was implemented in 100% of patients. CBT was performed systematically and was negative in 106 patients, revealing oropharyngeal flora in 40% of cases, polymicrobial flora in 50% and sterile samples in 10%. In the 101 patients with positive CBT, the bacteria isolated were penicillin-sensitive in 99%. All patients were successfully treated. In the light of the bacteriological results, no changes were made to the probabilistic antibiotic therapy introduced on admission.
CONCLUSION
CBT on drainage pus had no impact on the management of PTA. CBT is therefore unnecessary in patients with no comorbidities and no signs of severity at admission.
PubMed: 38631947
DOI: 10.1016/j.anorl.2024.03.003 -
The Laryngoscope Apr 2024Abscess tonsillectomy is performed during an active episode of quinsy. Apprehensions regarding an elevated bleeding risk have hindered its widespread acceptance. This... (Review)
Review
OBJECTIVE
Abscess tonsillectomy is performed during an active episode of quinsy. Apprehensions regarding an elevated bleeding risk have hindered its widespread acceptance. This study aims to assess the prevalence of post-tonsillectomy bleeding (PTB) associated with abscess tonsillectomy.
DATA SOURCES
A search was performed on August 27, 2023 in Medline, Embase, PubMed, Cochrane CENTRAL, and Web of Science databases.
REVIEW METHODS
The systematic review was conducted in adherence to the PRISMA guidelines. Pooled PTB rate was determined using a meta-analysis of proportions. The JBI tool was used to assess the quality of the included studies.
RESULTS
Of the 525 search records, 18 studies met the eligibility criteria for final analysis. These comprised of retrospective single-center analyses. The pooled prevalence of PTB was 6.65% (95% C.I. 4.01-9.81), and the return-to-theatre rate was 2.35% (95% C.I. 1.48-3.37). There was no difference in PTB rate between unilateral and bilateral tonsillectomy. However, the bipolar technique was associated with a higher PTB rate compared to cold steel dissection. The overall quality of the body of evidence was moderate.
CONCLUSION
Our study highlights the complications associated with abscess tonsillectomy. These findings contribute valuable insights into this potential treatment option for quinsy.
LEVEL OF EVIDENCE
N/A Laryngoscope, 2024.
PubMed: 38613457
DOI: 10.1002/lary.31449 -
Indian Journal of Otolaryngology and... Apr 2024Peritonsillar abscess is a polymicrobial infection with acute life threatening complications if not treated promptly. Primary objective is to find the anatomical factor...
Peritonsillar abscess is a polymicrobial infection with acute life threatening complications if not treated promptly. Primary objective is to find the anatomical factor for unilateral abscess formation and appropriate management protocols. Secondary objectives include the bacteriological study,antibiotic preference and comparison of crypt length of both tonsils post tonsillectomy to look for any significant association. A prospective study was carried out for one year in patients with peritonsillitis or peritonsillar abscess attending the Department of ENT in our hospital. Acute cases were treated by incision and drainage followed by IV antibiotics after taking pus or throat swab for culture and sensitivity. Patients further planned for interval tonsillectomy after 6 weeks followed by histopathological examination to compare the infected side and normal side. Crypt length measurements done to see any disparity which would have lead to the development of peritonsillar abscess unilaterally. In patients with peritonsillitis or peritonsillar abscess, histopathological examination of tonsils after interval tonsillectomy showed that risk of peritonsillitis or peritonsillar abscess were more on the tonsil with larger crypt length with more preponderance on left side and in males. This study concludes that deeper the crypt length,male sex, history of recurrent tonsillitis are main risk factors for development of peritonsillar abscess. Bacteriology showed Staphylococcus aureus against the most common Streptococcus Sp. Hence prompt use of antibiotics help in early recovery and reducing complications.
PubMed: 38566744
DOI: 10.1007/s12070-023-04401-0 -
Auris, Nasus, Larynx Jun 2024Previous studies show that the COVID-19 pandemic affected the number of surgeries performed. However, data on the association between the COVID-19 pandemic and...
OBJECTIVE
Previous studies show that the COVID-19 pandemic affected the number of surgeries performed. However, data on the association between the COVID-19 pandemic and otolaryngologic surgeries according to subspecialties are lacking. This study was performed to evaluate the impact of the COVID-19 pandemic on various types of otolaryngologic surgeries.
METHODS
We retrospectively identified patients who underwent otolaryngologic surgeries from April 2018 to February 2021 using a Japanese national inpatient database. We performed interrupted time-series analyses before and after April 2020 to evaluate the number of otolaryngologic surgeries performed. The Japanese government declared its first state of emergency during the COVID-19 pandemic in April 2020.
RESULTS
We obtained data on 348,351 otolaryngologic surgeries. Interrupted time-series analysis showed a significant decrease in the number of overall otolaryngologic surgeries in April 2020 (-3619 surgeries per month; 95% confidence interval, -5555 to -1683; p < 0.001). Removal of foreign bodies and head and neck cancer surgery were not affected by the COVID-19 pandemic. In the post-COVID-19 period, the number of otolaryngologic surgeries, except for ear and upper airway surgeries, increased significantly. The number of tracheostomies and peritonsillar abscess incisions did not significantly decrease during the COVID-19 pandemic.
CONCLUSION
The COVID-19 pandemic was associated with a decrease in the overall number of otolaryngologic surgeries, but the trend differed among subspecialties.
Topics: Humans; COVID-19; Japan; Otorhinolaryngologic Surgical Procedures; Retrospective Studies; Female; Male; Middle Aged; Aged; Adult; SARS-CoV-2; Interrupted Time Series Analysis; Head and Neck Neoplasms; Foreign Bodies; Child; Adolescent
PubMed: 38564845
DOI: 10.1016/j.anl.2024.03.002 -
Diagnostic Cytopathology Jul 2024Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) is a newly established immunodeficiency-related disease. Herein, we report a case of EBVMCU and focus on its...
Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) is a newly established immunodeficiency-related disease. Herein, we report a case of EBVMCU and focus on its cytological usefulness for diagnosis. An 82-year-old man manifested pharyngalgia, dysphagia, and oral pain. His medical history included rheumatoid arthritis that had been treated with methotrexate. Clinically, peritonsillar abscess was suspected, but since neoplastic lesions, including malignant lymphoma (ML), could not be excluded, a series of cytohistological examination was attempted. Despite some alarming findings (e.g., frequent mitoses), fine-needle aspiration and touch imprint cytology consistently revealed a heterogeneous population of lymphoid and plasmacytoid cells with mild nuclear atypia. The final diagnosis of EBVMCU was established based on the permanent histologic specimen; however, retrospectively, cytology was more representative of the benign nature of the lesion than histology, helping a great deal to differentiate it from ML. Cytology can be a useful tool for the correct diagnosis of EBVMCU.
Topics: Humans; Male; Palatine Tonsil; Epstein-Barr Virus Infections; Aged, 80 and over; Herpesvirus 4, Human; Ulcer; Biopsy, Fine-Needle; Cytodiagnosis; Cytology
PubMed: 38533980
DOI: 10.1002/dc.25309 -
Auris, Nasus, Larynx Jun 2024Short-term recurrence is common in patients with peritonsillar cellulitis and abscesses, leading to socioeconomic problems. Early switching from intravenous to oral...
OBJECTIVE
Short-term recurrence is common in patients with peritonsillar cellulitis and abscesses, leading to socioeconomic problems. Early switching from intravenous to oral antibiotics is feasible for treating certain diseases. However, reports on early switching and total antibiotic administration duration in peritonsillar cellulitis and abscesses are limited. This study aimed to determine the appropriate antibiotic therapy duration and examine the impact of early oral switch therapy on peritonsillar cellulitis and abscesses.
METHODS
We retrospectively identified 98,394 patients who received antibiotic therapy during hospitalization for peritonsillar cellulitis and abscesses between July 1, 2010, and December 31, 2019, using the Japanese Diagnosis Procedure Combination database.
RESULTS
Propensity score matching analysis revealed no significant between-group difference in the rehospitalization rate (early oral switch therapy and long intravenous therapy: 1.7 % [198 of 11,621] vs. 2.0 % [234 of 11,621], odds ratio [OR] 0.84, 95 % confidence interval [CI] 0.70-1.02). A long total duration of antibiotic therapy (reference: 1-9 days) was associated with a low risk of rehospitalization (10-14 days: OR 0.86, 95 % CI 0.78-0.95; 15+ days: OR 0.51, 95 % CI 0.38-0.66).
CONCLUSION
Early oral switch therapy may be a viable option for treating patients with peritonsillar cellulitis and abscesses in good condition who can tolerate oral intake. No less than 10 days of antibiotic therapy is desirable.
Topics: Humans; Female; Male; Anti-Bacterial Agents; Retrospective Studies; Peritonsillar Abscess; Cellulitis; Middle Aged; Adult; Recurrence; Patient Readmission; Aged; Administration, Oral; Propensity Score; Cohort Studies; Administration, Intravenous
PubMed: 38520976
DOI: 10.1016/j.anl.2023.12.006