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At least 631 records · Page 35Linked to original sources
PubMed1993

Lemierre syndrome: the forgotten disease.

Lemierre syndrome is characterized by an acute oropharyngeal infection, suppurative thrombophlebitis of the internal jugular vein, anaerobic sepsis, and metastatic infections. Before the discovery of antibiotics, this disease usually was fatal. We report the case of a patient with all of these findings, indicating that Lemierre syndrome still is seen today. Prompt recognition, abscess drainage, and appropriate antibiotic coverage result in complete recovery in most patients.

Adult↗
PubMed1992

The management of quinsy--a prospective study.

A prospective study for the treatment of quinsy was undertaken between January 1989 and September 1991. This was to determine whether abscess tonsillectomy reduces inpatient stay without increasing operative risk compared to incision and drainage combined with interval tonsillectomy. Fifty-three patients were entered into the study. Twenty-one had abscess tonsillectomy and 32 had incision and drainage. This study showed that there is a 95 per cent probability that abscess tonsillectomy reduces hospital stay by between 2.04 and 4.84 (Student's test t = 5.01; df = 31, p < 0.001) days compared to incision and drainage followed by interval tonsillectomy. This is a significant saving in time and resources. Abscess tonsillectomy reduces patients lost to follow-up, avoids the social inconvenience of a second admission, effectively relieves symptoms, treats a contralateral abscess and is the only method of treating children with a quinsy. We recommend abscess tonsillectomy should be performed for quinsy where expertise and facilities are available.

Adult↗
PubMed1992

[Acute tonsillitis--peritonsillitis--paratonsillar abscess: Differential diagnosis by flexible endosonography].

The role of flexible endosonography in diagnosis of acute tonsillitis and their complications was investigated in 59 patients. Our results show that flexible endosonography enables the examiner to differentiate acute tonsillitis from peritonsillitis and paratonsillar abscess. In particular, abscesses of retrotonsillar spread possibly leading to life-threatening complications can be detected in an early stage.

Acute Disease↗
PubMed1991

[Retrotonsillar abscess. Diagnosis by flexible endosonography].

A retrotonsillar abscess is a dangerous complication of acute tonsillitis that can be fatal if treatment is delayed. We report the pre-operative findings of flexible endosonography and transcutaneous sonography of a patient with retrotonsillar abscess. The results show, that the new digitally guided, flexible probes of endosonography improve the diagnosis of paratonsillar abscess and are superior to transcutaneous sonography especially for delineating retrotonsillar spread.

Diagnosis, Differential↗
PubMed1995

A prospective study of anaesthesia for quinsy tonsillectomy.

A prospective study of 50 adult quinsy tonsillectomy anaesthetics was performed. There were no significant anaesthetic or surgical complications and the mean intra-operative blood loss was 176 ml. The Mallampati score did not correlate with the Cormack and Lehane glottic view and there were no difficult intubations. Pre-operative trismus resolved completely during induction in 77.4% of cases. We concluded that the Mallampati grading system is not applicable in quinsies and in cases with palatopharyngeal arch distortion, that trismus in quinsies is due to muscle spasm and resolves completely during induction in most cases and that pre-anaesthetic drainage of the abscess together with rehydration and antibiotics are important contributing factors to safe anaesthesia for quinsy.

Adolescent↗
PubMed1989

Mucocutaneous lymph node syndrome (Kawasaki syndrome) mimicking a suppurative parapharyngeal space infection. Case report and review of the literature.

A six-year-old girl presented with fever, trismus and a very tender, enlarged submandibular mass. CT-scanning showed a right parapharyngeal mass and enlarged cervical nodes in the posterior triangle. Surgical exploration of the area failed to reveal an abscess. Subsequently the clinical criteria for the diagnosis of Kawasaki syndrome were met. This unusual presentation is compared with previously reported cases in the literature.

Child↗
PubMedDate not supplied

Peritonsillitis: abscess or cellulitis?

Peritonsillitis encompasses both cellulitis and abscess. To determine the distinguishing factors for cellulitis and abscess, we reviewed 29 patients, 15 with cellulitis and 14 with abscess. Common presenting complaints included dysphagia, trismus, drooling, voice change and fever. Unilateral tonsillar enlargement was usually present, and uvular deviation was noted in 10 of 29 patients. The mean ages of patients with abscess was 15.0 years, and that of patients with cellulitis was 10.8 years. The two groups differed significantly by age (P = 0.02), and discriminant analysis showed age, dysphagia and drooling to be discriminators for abscess patients, while bilaterality or fever were not. Trismus was a discriminator for cellulitis patients. Etiology for abscess included Group A and non-Group A beta-hemolytic streptococci, Group D streptococcus, alpha-streptococcus, anaerobic diphtheroids and coagulase-negative staphylococci. The etiology of the cellulitis was Group A and non-Group A beta-hemolytic streptococci and Streptococcus pneumoniae. Peritonsillitis appeared to increase in frequency. On presentation patients with cellulitis are similar to patients with abscess. Abscess is more likely in adolescents. Recommended therapy is intravenous penicillin and prompt drainage for patients failing to respond.

Adolescent↗
PubMed1980

[Pharyngeal abscesses following tonsillectomy (author's transl)].

A few weeks after tonsillectomy two patients presented with recurring pharyngeal abscesses, and a fistula and a cyst were identified as the probable reasons for these. The embryology and differential diagnosis is discussed. The Grisel Syndrome and its presentation following tonsil remnant infection is demonstrated in another patient.

Adult↗
PubMed2003

The admission of patients with peri-tonsillar abscess to a general ENT ward and its influence on secondary post-tonsillectomy haemorrhage.

Patients with peri-tonsillar abscess require hospitalization. The aim of this prospective study was to determine whether the admission of patients with peri-tonsillar abscess to the same ward as those undergoing tonsillectomy influences the incidence of secondary post-tonsillectomy haemorrhage. We included all adult patients undergoing in-patient tonsillectomy (n = 183) and all patients with proven peri-tonsillar abscess (n = 46) over a 1-year period. Both patient groups were nursed in the same general otolaryngology ward. The operation dates of those patients who developed secondary post-tonsillectomy haemorrhage were matched to the dates when patients with peri-tonsillar abscess were admitted. Out of the 71 patients who had tonsillectomy on days when patients with peri-tonsillar abscess were admitted, 10 developed secondary haemorrhage. Out of the 112 patients who had tonsillectomy on days when no one in the ward had peri-tonsillar abscess, 16 developed secondary haemorrhage. No difference was demonstrated (chi2 = 0.0014, P > 0.05). In this study, admission of patients with peri-tonsillar abscess to a general otolaryngology ward does not influence the incidence of secondary post-tonsillectomy haemorrhage in patients undergoing elective surgery.

Adolescent↗
PubMed1997

[Abscess in the posterior third of the tongue. A clinical case].

A case of lingual abscess visualized by computed tomography is reported. The review of the literature demonstrated the difficulty of diagnosing these cases. Protection and surveillance of the upper airways is important. Computed tomography is the key to diagnosis.

Adult↗
PubMedDate not supplied

[Microflora of the paratonsillar abscesses].

The species composition of aerobic and anaerobic microflora of paratonsillar abscesses was investigated in 20 patients. It was found that obligate nonspore-forming anaerobic bacteria predominated in the pus of the abscess cavity. Anaerobic infection was diagnosed rapidly by gas-liquid chromatography. Anaerobic bacteria were shown to be highly sensitive to clindamycin and metronidazol.

Adolescent↗
PubMed2006

Tonsillar abscess formation due to herpes simplex type-1 in a severely immunocompromised stem cell transplant patient with chronic myeloid leukemia.

Herpes simplex virus (HSV) causes life-threatening infections in immunocompromised patients such as transplant recipients and patients with hematologic malignancies. We herein describe the case of a patient with chronic myeloid leukemia blastic transformation who developed severe herpetic tonsillitis complicated by tonsillar abscess formation. Abscess formation was determined by computed tomography, whereas tonsillitis due to HSV was confirmed by pathologic and immunohistochemical examinations of the tonsillar biopsy. For molecular confirmation, HSV DNA was amplified by LightCycler PCR and type (HSV-1) determined by melting point analysis. The patient responded promptly to antiviral treatment and there were no signs of recurrent infection at the follow-up. To our knowledge, this case is unique for being the first case of tonsillar abscess formation due to HSV-1, also emphasizing the importance of herpetic infections in the differential diagnosis of oropharyngeal small-sized lesions in the immunocompromised patient population.

Adult↗
PubMed2002

[Granulocytic sarcoma of the tonsils associated with myelodysplastic syndrome].

HISTORY AND ADMISSION FINDINGS: A 60-year-old man with anaemia was found to have a myelodysplastic syndrome (MDS) which was classified as refractory anemia with ringsideroblasts (RAEB). Because of severe fever the patient was hospitalized. Waldeyer's throat ring revealed signs of acute inflammation. LABORATORY FINDINGS: Indicated severe anemia and thrombocytopenia. Leucocytes were 8000/ml with a pathological shift to the left (1920/ml blasts). CRP (4.7 g/dl) and BSG (59/91mm) were abnormal. An axial CT of the neck showed a left sided paratonsillar abscess. DIAGNOSIS AND THERAPY: The tonsillitis was treated with antibiotics. Persistent fever up to 39.8 degrees C suggested resistance to therapy. After three weeks the patient developed septicemia and died. Autopsy revealed MDS with excess of blasts in transformation (RAEBT-t). Granulocytic sarcoma was found in the throating where there was no paratonsillar abscess. Generalized miliary tuberculosis was proved at autopsy, explaining the continuous fever resistant to antibiotic treatment. CONCLUSION: Granulocytic sarcoma is rarely associated with myelodysplastic syndrome. Deficiency in the immune system may facilitate the occurrence of miliary tuberculosis.

Anemia, Refractory, with Excess of Blasts↗
PubMed1987

Adenitis, adenopathy, and abscesses of the head and neck.

The emergency clinician will continue to be called on to evaluate inflammatory processes of the head and neck on a regular basis. We have attempted to describe the broad range of these problems, as well as our current considerations for diagnosis and management. Our goal has been to promote accurate diagnosis to allow early detection of situations calling for prompt medical or surgical intervention.

Anti-Bacterial Agents↗
PubMed1995

An unexpected cause of upper airway obstruction.

A three-year-old boy with a swelling on the right side of his neck was suspected of having a parapharyngeal abscess after clinical examination and CT scan (computed tomography scan) of this region. Later it became clear, that the swelling was caused by an aneurysm of the internal carotid artery. This case report describes the pitfalls and difficulties encountered in the diagnostic course and treatment planning.

Airway Obstruction↗
PubMedDate not supplied

[Clinical features of nonclostridium anaerobic infection in the pathology of E.N.T. organs].

The study of clinical features of nonclostridial anaerobic infection in 80 patients with purulent and inflammatory pathologies of ENT-organs (purulent sinusitis, purulent otitis media, paratonsillar abscesses) showed them to be as follows: prolonged, slow and often subclinical development of the disease; disseminated necrotic changes of tissues; disagreement between the level of clinical symptoms and destructive changes (prevalence of destructive changes over clinical symptoms); phenomenon of false anesthesia; existence of crumbs-like pus with a strong bad smell sometimes filled with air bubbles; limited bleeding from cut tissues.

Bacteria, Anaerobic↗