Peritonsillar abscess

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Peritonsillar abscess
File:PeritonsilarAbsess.jpg Peritonsillar abscess
Synonyms	Quinsy
Pronounce	N/A
Specialty	N/A
Symptoms	Sore throat, fever, drooling, trismus, muffled voice
Complications	Airway obstruction, aspiration pneumonia, sepsis
Onset	Typically young adults
Duration
Types	N/A
Causes	Bacterial infection
Risks	Tonsillitis, smoking, chronic lymphocytic leukemia
Diagnosis	Physical examination, ultrasound, CT scan
Differential diagnosis	Epiglottitis, retropharyngeal abscess, tonsillitis
Prevention
Treatment	Antibiotics, surgical drainage
Medication	Penicillin, clindamycin
Prognosis	Generally good with treatment
Frequency	30 per 100,000 per year
Deaths	N/A

Peritonsillar abscess Peritonsillar abscess, often abbreviated as PTA, is a clinical condition characterized by the collection of pus in the peritonsillar space, a potential space surrounding the palatine tonsils. It is a complication of acute tonsillitis and is one of the most common deep neck infections.

File:Absceso periamigdalino.png

Absceso periamigdalino

Throat with Tonsils 0012J

File:PeritonsilarAbsMark.png

PeritonsilarAbsMark

File:PeritonsilarAbsess.jpg

PeritonsilarAbsess

Pathophysiology

The pathophysiology Pathophysiology of a peritonsillar abscess is generally initiated by acute tonsillitis, leading to inflammation and subsequent pus formation in the peritonsillar space. The infection often involves a mixture of aerobic and anaerobic bacteria, with the most common pathogens being group A streptococcus Streptococcus pyogenes and Fusobacterium.

Clinical Presentation

Patients with a peritonsillar abscess often present with severe sore throat, fever, drooling, and difficulty swallowing (odynophagia) Odynophagia. Trismus, or reduced opening of the jaw, is also common due to the involvement of the pterygoid muscles. The voice of the patient may become muffled or exhibit a "hot potato" voice, due to the swelling of the tissues around the tonsils.

Diagnosis

Diagnosis of a peritonsillar abscess usually involves a thorough history and physical examination, including an oral examination. During oral examination, one might observe a swollen, displaced uvula and an enlarged, erythematous tonsil with or without visible pus. Additional diagnostic tools such as computed tomography (CT) scan Computed tomography or ultrasound can be used to confirm the diagnosis and rule out other differential diagnoses such as peritonsillar cellulitis.

Treatment

The primary treatment of a peritonsillar abscess involves drainage of the abscess, either through needle aspiration, incision and drainage, or tonsillectomy Tonsillectomy, along with antibiotic therapy to cover the common causative organisms. Pain control and hydration are also important aspects of management.

Prognosis

With timely and appropriate treatment, the prognosis for a peritonsillar abscess is generally excellent. However, potential complications can arise if the condition is left untreated, including the spread of infection to deeper neck tissues and airway obstruction.

Epidemiology

Peritonsillar abscesses are relatively common, particularly among adolescents and young adults. They can occur at any age but are less frequent in younger children and the elderly.

References

• Herzon, FS. (1995). "Harris P. Mosher Award thesis. Peritonsillar abscess: incidence, current management practices, and a proposal for treatment guidelines". Laryngoscope.
• Powell, J., Wilson, J.A. (2012). "An evidence-based review of peritonsillar abscess". Clinical Otolaryngology.
• Walker, P., Gillies, D. (2007). "Primary versus secondary incision and drainage for peritonsillar abscess". Cochrane Database of Systematic Reviews.

External Links

• [American Academy of Otolaryngology – Head and Neck Surgery - Tonsils and Adenoids](https://www.entnet.org/content/tonsils-and-adenoids)
• National Health Service (NHS) - Quinsy

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