Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Peritonsillar Abscess”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMed1982

Changing face of treatment of peritonsillar abscess.

Changing trends in the treatment of peritonsillar abscess are demonstrated by this retrospective study of 74 patients treated from 1975 through 1980 by a standardized regimen. This included needle aspiration at three points, intravenous antibiotics, hydration, and pharyngeal douches. The patients ages ranged from 11 to 73 years. There were 45 males and 29 females. Needle aspiration was positive in 52 patients (70%) and repeat aspiration was necessary in 10% of patients. Tonsillectomy was performed in 42 patients. No recurrent peritonsillar abscesses occurred during the 1 to 5 year follow-up of the 32 patients who did not have tonsillectomy. Recurrent tonsillitis did occur in 4 of these patients and 3 of them had a past history of recurrent tonsillitis. The authors conclude that treatment of peritonsillar abscess should consist of needle aspiration, intravenous antibiotics and supportive measures. Interval tonsillectomy should be performed only when there is a history of recurrent tonsillitis or previous peritonsillar abscess.

Adolescent↗
PubMed1993

Peritonsillar abscess, retropharyngeal abscess, mediastinitis, and nonclostridial anaerobic myonecrosis: a case report.

Peritonsillar abscess is a potentially life-threatening complication of acute tonsillitis. On occasion, peritonsillar abscess can extend to neck spaces and/or to the mediastinum. We describe a case of a patient with a peritonsillar abscess that extended to the neck, producing bilateral retropharyngeal abscesses and myonecrosis of the strap muscles. Culture of a specimen of the necrotic muscle yielded Prevotella intermedia, Prevotella buccae, Lactobacillus catenaforme, another Lactobacillus species, Peptostreptococcus anaerobius, and some nonanaerobes. Culture of the peritonsillar abscess yielded P. intermedia and P. buccae plus P. anaerobius, Peptostreptococcus asaccharolyticus, Bifidobacterium dentium, viridans and group F streptococci, and Citrobacter diversus. Culture of the retropharyngeal abscess yielded Fusobacterium nucleatum and Actinomyces odontolyticus in addition to most of the aforementioned organisms. The patient underwent repeated drainage and debridement procedures and was treated with various antimicrobial agents and ultimately recovered. This case highlights the polymicrobial nature of peritonsillar abscess and the serious complications that this infection may lead to.

Abscess↗
PubMed1981

Aerobic and anaerobic bacteriology of peritonsillar abscess in children.

Aspiration of peritonsillar abscess (quinsy) was aseptically performed in 16 children. Patients' median age was 10 years (range 6 to 17 years), and 12 were males. Unilateral abscess was present in all but one child. All aspirates were cultured for aerobes and anaerobes and yielded bacterial growth in all patients. Anaerobes were isolated in all patients; in 3 patients (19%), they were the only organism isolated, and in 13 (81%), they were mixed with aerobes. There were 91 anaerobic isolates (5.7 per specimen): 42 Bacteroides sp. (including 23 B. melaninogenicus, 5 B. oralis and 4 B. ruminicola ss. brevis); 18 anaerobic Gram-positive cocci (including 10 Peptostreptococcus sp., 4 Peptococcus sp. and 4 microaerophilic streptococci); 15 Fusobacterium sp.; and 3 Clostridium sp. There were 32 aerobic isolates (2.0 per specimen): 11 gamma-hemolytic streptococci, 8 alpha-hemolytic streptococci, 4 Group A beta-hemolytic streptococci, 4 Haemophilus sp. and 3 S. aureus. Beta-lactamase production was noted in 13 isolates recovered from 11 patients (68%). These were all isolates of S. aureus (3), 8 of 23 B. melaninogenicus (35%), and 2 of 5 B. oralis (40%). Our findings indicate the major role of anaerobic organisms in the polymicrobial etiology of peritonsillar abscesses in children, and demonstrate the presence of many beta-lactamase-producing organisms in two thirds of the patients.

Adolescent↗
PubMed2006

An outpatient medical treatment protocol for peritonsillar abscess.

Several surgical methods are used to treat peritonsillar abscess, but no protocol for outpatient medical treatment has yet been published. Between February 2002 and February 2005, we treated 98 peritonsillar abscess patients with an outpatient medical regimen that involved hydration, antibiotics, steroids, and good pain control. All patients were Native Americans, who are known to have a particularly high incidence of peritonsillar abscess. The medical regimen was generally successful, as only 4 patients (4.1%) subsequently required post-treatment needle aspiration or incision and drainage. We conclude that the medical protocol described herein provides practitioners with a viable noninvasive alternative for treating peritonsillar abscess.

Adolescent↗
PubMed1990

Peritonsillar abscess: the treatment options.

Peritonsillar abscess is the second most common ENT emergency admission at our hospital. The optimal management has been a subject of discussion for years. This paper reviews 51 patients and the literature to question the traditional medical/surgical managements.

Adolescent↗
PubMed2006

Peritonsillar abscess in a 40-day-old infant.

A peritonsillar abscess is one of the most commonly occurring deep space infections of the head and neck in adults and children. A peritonsillar abscess that appears in newborns, however, is extremely rare. The treatment of a peritonsillar abscess requires both the selection of appropriate antibiotics and the best procedure to remove the abscessed material. We report a case of a peritonsillar abscess in a 40-day-old infant who was treated with antibiotic therapy alone.

Humans↗
PubMed1983

Septic necrosis of the internal carotid artery: a complication of peritonsillar abscess.

Septic necrosis of the internal carotid artery is a major complication of peritonsillar abscess. Although once a common complication, its occurrence is rare since the introduction of antibiotics. A 12-year-old girl was referred to our institution after a false aneurysm of the internal carotid artery had been entered during routine tonsillectomy for a peritonsillar abscess. Review of the literature and features of the present case demonstrate the following findings suggestive of erosion of the internal carotid artery as a result of peritonsillar abscess: (1) spontaneous hemorrhage from a peritonsillar abscess, (2) persistent peritonsillar swelling after resolution of symptoms of peritonsillar abscess, (3) ipsilateral Horner's syndrome, and (4) otherwise unexplained cranial nerve palsies (nerves IX, X, XI, and XII).

Carotid Artery Diseases↗
PubMed1984

Necrotizing fasciitis as a lethal complication of peritonsillar abscess.

Abscesses of the peritonsillar region rarely lead to serious complications. Incision and drainage, antibiotic therapy, and subsequent tonsillectomy is the accepted method of treatment. Two cases of fatal necrotizing fasciitis following peritonsillar abscess are presented. The entity of necrotizing fasciitis in the head and neck is discussed with respect to its presentation, diagnosis, and treatment.

Anti-Bacterial Agents↗
PubMed2005

The epidemiology of peritonsillar abscess disease in Northern Ireland.

OBJECTIVES: 1. To describe the epidemiology of peritonsillar abscess disease in Northern Ireland. 2. To describe the impact of the nature of microbiological sampling on culture results. METHOD: Retrospective review of cases of peritonsillar abscess identified by diagnostic coding in three centres in Northern Ireland between August 2001 and July 2002. RESULTS: One hundred and twenty eight cases of confirmed peritonsillar abscess were treated as inpatients accounting for 1 in 10,000/year of the population in the hospitals' catchment area. The mean age was 26.4 (range 9-78) years. Sixty-nine patients were male; the mean length of hospital stay was 3 days. Culture yield was greatest from needle aspirates; throat swabs and blood cultures were typically unhelpful. Beta haemolytic streptococci were the most common isolates. Resistance among Group A haemolytic streptococci to macrolide antibiotics was present in 26% of isolates. Heterophile antibody testing was routine and revealed that Epstein-Barr virus infectious mononucleosis had a prevalence of 1.8% in this group of patients. CONCLUSION: In this population, although there were many similarities with the clinical features reported by other investigators, there were also several differences. Notably, we found a comparatively low proportion of anaerobic infections. Although cultures results did not influence individual patient treatment, reviewing data derived from populations is valuable for guiding empirical antibiotic therapy. SUMMARY: The epidemiology of peritonsillar abscess disease is not well described. Other investigators describing the bacteriology give differing results, presumably reflecting different countries and techniques. The need for routine microbiological testing has been questioned in several reports, but the benefit of routine culture and sensitivity data for planning empirical antibiotic treatment has not been explored. We present a retrospective review of 128 cases of confirmed peritonsillar abscess in Northern Ireland from August 2001 to July 2002. The annual population incidence in this region is 1 in 10,000/year. In this group concurrent Epstein-Barr virus infection was found to have a prevalence of 1.8%. The yield of positive cultures from routine microbiological sampling was low in comparison to that reported in detailed prospective studies, from various countries. Needle aspiration was the best technique for obtaining pus for culture; throat swabs and blood cultures were unhelpful. Culture results did not affect individual patient treatment, but may have a potentially useful role for selecting empirical therapy.

Adolescent↗
PubMed1981

Peritonsillar abscess. I. Cases treated by incision and drainage: a follow-up investigation.

The purpose of the present follow-up investigation was to evaluate the indications for tonsillectomy à chaud in the presence of a peritonsillar abscess. Of 76 consecutive patients treated for peritonsillar abscess, 45 were treated by incision and drainage, and no tonsillectomy à froid was planned. None of these patients had had previous peritonsillar abscess or recurrent tonsillitis; therefore tonsillectomy was not indicated. A follow-up investigation including 44 of these 45 patients showed that among patients under 30 years of age, 63 per cent had another peritonsillar abscess or recurrent tonsillitis during he follow-up period. Within an average period of 3 years, 41 per cent in this group underwent tonsillectomy. Among patients older than 30 years only 12 per cent had recurrent tonsillar symptoms, and in no case was tonsillectomy performed. The indication for tonsillectomy à chaud is discussed, and the method is recommended as a routine in peritonsillar abscess in patients under 30 years old, whereas conservative treatment with incision and drainage is recommended in patients older than 30 years if the patient has had no previous peritonsillar abscess or recurrent tonsillitis.

Adolescent↗
PubMed1988

Semiquantitative culture results and pathogenic significance of obligate anaerobes in peritonsillar abscesses.

We studied the bacteria in consecutive peritonsillar abscesses using semiquantitation of the primary culture findings and correlated the results to clinical parameters. Puncture-aspirated pus from 42 abscesses yielded 133 isolates. Group A streptococci were isolated 10 times and, unlike other bacteria, were isolated 4 times in pure culture; other beta-hemolytic streptococci were found in 8 abscesses, and anaerobes were found in 28. The infections were polymicrobial, with two to seven bacteria in 83%. Anaerobes were more abundant than nonanaerobes; members of the genera Streptococcus, Bacteroides, Peptostreptococcus, and Fusobacterium were the most important quantitatively, considering both frequency and abundance. In patients with ongoing antibiotic treatment, nonanaerobes (but not anaerobes) were less abundant than in untreated patients. The abundance of obligate anaerobes (specifically cocci and gram-positive rods) correlated to the severity of illness as defined by fever and short duration before hospitalization. With other groups of bacteria, no such correlation was found. The correlation was not explained by a difference between the antibiotic-treated and the untreated patients. The results indicate the value of the semiquantitation of culture data and the frequency and pathogenic significance of obligate anaerobes in peritonsillar abscesses.

Adolescent↗
PubMed1995

Microbiological features and pathogenesis of peritonsillar abscesses.

Samples of pus aspirated from 53 peritonsillar abscesses were examined in detail for aerobic and anaerobic bacteria, and the microbiological results correlated with clinical data in 44 cases. In 45 samples (85%) cultures were positive: 7 yielded organisms consistent with an aerobic infection, mainly Lancefield group A beta-haemolytic streptococci (5/7), and 38 yielded organisms consistent with an anaerobic infection. The anaerobic infections were usually mixed, but in two cases Fusobacterium necrophorum was isolated in pure culture. Peptostreptococcus micros and Streptococcus milleri were the predominant isolates in this group. Direct Gram stain smear and gas-liquid chromatography were useful indicators of the type of infection present. Samples from ten patients (18.9%) grew one or more beta-lactamase-producing isolates. Of the 25 patients prescribed antibiotics by their general practitioners prior to admission, 18 received one or more beta-lactam antibiotics. Most cases of peritonsillar abscess were due to mixed anaerobic infections, Lancefield group A beta-haemolytic streptococci playing a central role in only a minority of cases. In light of these findings and the possibility of infection with beta-lactamase-producing isolates, it is suggested that the first-line antibiotic therapy in this group of patients should include a chemotherapeutic agent directed against anaerobic bacteria.

Adolescent↗
PubMed1985

Bilateral peritonsillar abscesses and quinsy tonsillectomy.

Two patients presented with history, symptoms, and clinical findings suggesting unilateral peritonsillar abscesses. At the time of quinsy tonsillectomy, the patients were found to have pus present in the contralateral peritonsillar spaces. These findings prompted a review of the literature to determine the actual frequency of bilateral peritonsillar abscesses and to reassess the approach to treatment of patients presenting with peritonsillar abscesses.Peritonsillar abscess frequently develops following the onset of acute tonsillitis, and it is possible that this process occurs bilaterally with the developmental stages of the abscesses being different on each side. Intensive antibiotic treatment, incision and drainage of the obvious abscess probably suppresses the development of and masks the presence of the abscess on the opposite side.Quinsy tonsillectomy has been indicated previously for patients not responding to intravenous antibiotic treatment and incision and drainage of their peritonsillar abscess. The possibility of a subclinical contralateral peritonsillar abscess being present is an additional indication for proceeding with a quinsy tonsillectomy, especially in patients who remain febrile after apparent satisfactory drainage of the clinically evident abscess.

Adult↗
PubMed1985

Peritonsillar abscess: bacteriological evaluation.

The pus from a series of 41 peritonsillar abscesses was examined bacteriologically. In the majority of the abscesses a mixed bacterial flora was found. The specimens yielded 0-7 different bacterial species per abscess (mean 3.0). One species alone was isolated only in five cases (12.5%). Both anaerobic and aerobic bacteria were isolated from the specimens of 25 patients (61%), only anaerobes from two specimens (4.9%), and only facultative bacteria from 12 specimens (29%). Beta haemolytic streptococci were cultured in 43.9% of the cases, but Streptococcus pyogenes group A in only 10 cases (24.4%). Thus, the pus of the peritonsillar abscess seems to be caused by a mixed bacterial infection, where anaerobic bacteria play a significant role. Indications of tonsillectomy in cases with peritonsillar abscess are discussed.

Adolescent↗
PubMed1987

Carotid hemorrhage: a complication of peritonsillar abscess.

Carotid hemorrhage secondary to peritonsillar abscess occurs infrequently today because of the effectiveness of antibiotic therapy. When it does occur, however, emergency physicians unfamiliar with such a complication may have difficulty making its diagnosis and instituting appropriate therapy. Prevention is the easiest way to treat septic erosion. Abscesses are treated best with penicillin or, in the allergic patient, clindamycin followed by incision and drainage. Once the abscess has eroded into the carotid artery, it usually must be tied off to control the subsequent massive bleeding.

Adolescent↗
PubMed1975

Influence of the collection and transport of specimens on the recovery of bacteria from peritonsillar abscesses.

In 30 patients with peritonsillar abscesses, pus was obtained by aspiration and by taking a swab after incision; bacterial recovery was compared. Although processed in the laboratory within 2 h, swab speciments gave results comparable to syringe specimens in only 9 of 13 patients with beta-hemolytic streptococci and 7 of 25 patients with anaerobic bacteria. Both kinds of microorganisms were lost in some cases but appeared as additional flora in others. The poor results from the swab technique was ascribed to overgrowth of respiratory flora contaminating the sample after incision. In aspirated pus kept in the syringe, or transferred to anaerobic transporters, the microbial flora was unchanged for 24 to 48 h. Some anaerobes also survived on agar slants for 24 h, but specially designed anaerobic transporters are recommended.

Anaerobiosis↗
PubMed1981

Peritonsillar abscesses in children.

A follow-up retrospective study was performed on 41 children who presented with peritonsillar abscesses from 1970-1980. The ages ranged from 3 to 16 years, with the mean age of 10 years. There were 26 females and 15 males. The abscesses were predominantly left-sided (28 vs. 13 right-sided) and the mean duration of symptoms was 3 days. Of the patients, 39% had been treated with antibiotics prior to the abscess development. Only 15% of the patients had a documented past history of exudative tonsillitis. Of the 41, 1 patient was lost to follow-up, and 11 underwent tonsillectomy for the abscess. Thus, 29 patients were reviewed who received no surgical therapy for their peritonsillar abscess other than incision and drainage. These patients were contacted for an interval history with a period of follow-up ranging from 6 months to 10 years. Only 2 of the 29 patients (7%) had recurrent abscesses. Two other patients (7%) had further recurrent bouts of exudative tonsillitis but not abscesses. These 4 children were in an initial group of 6 who had a prior history of documented tonsillitis. The incidence of recurrent peritonsillar abscesses reported in the literature has ranged from 7.6 to 16% in series which were comprised mainly of adults. The low incidence of recurrent abscesses (7%) in this series would indicate a need to reevaluate the indication for tonsillectomy for peritonsillar abscess in the pediatric age group. The authors recommend that tonsillectomy be performed in those children who present with a previous history of documented tonsillitis or suffer a complication at the time of the first abscess (neck abscess or airway compromise).

Adolescent↗
PubMed2006

A retrospective study of peritonsillar abscess in Riyadh Medical Complex [corrected].

OBJECTIVE: To investigate and study the management pattern of peritonsillar abscess, the male to female ratio and incidence. Also, to evaluate the causative organism isolated from abscess and reported by culture/sensitivity (C/S). METHODS: This study has been designed as a single centered retrospective hospital based study. We carried out this study in the Department of ENT, Riyadh Medical Complex, Saudi Arabia from 2000 to 2004. We gathered the data via survey (5 years). There were 81 patients admitted for the management of peritonsillar abscess. RESULTS: Mean age of patients was 22 years (range 10 to 60 years; 44 male, 37 female). The hospital stay varies from 1-8 days with a mean of 4 days. The left side is more involved. Treatment consisted mainly incision/drainage under local anesthetic in 47 patients (58%), while 5 cases (6%) were carried out under general anesthetic. Aspiration and conservative treatment was noted in 25 (31%) cases, abscess tonsillectomy was carried out in 3 (4%) cases. The most common microorganisms isolated from C/S is Group A beta hemolytic streptococcus (17/81 [21%]). Penicillin G + Flagyl (49/81 [60%]) were the most common antibiotics used. No case of bilateral peritonsillar abscess was found and there is no consensus regarding the best technique. Options include needle aspiration, incision and drainage and immediate tonsillectomy. CONCLUSION: Peritonsillar abscess remain one of the acute admission in the Department of Otolaryngology at Riyadh Medical Complex, Riyadh. Incision/drainage remains the gold standard treatment, Penicillin G + Flagyl combinations are the cornerstones.

Adolescent↗