Complications of peritonsillar abscess.

Area of Science:

• Otolaryngology
• Infectious Diseases
• Microbiology

Background:

• Peritonsillar abscess (PTA) typically resolves with drainage and antibiotics.
• However, severe complications can arise from spreading infections.
• The bacterial causes and optimal treatment for PTA remain debated.

Purpose of the Study:

• To catalog recognized complications of PTA.
• To identify bacteria involved in PTA complications.
• To analyze the timing of PTA complication development.

Main Methods:

• Systematic literature searches of Medline and EMBASE databases.
• Data extraction from reported cases of PTA with complications.

Main Results:

• Seventeen PTA complications were identified; descending mediastinitis, para/retropharyngeal abscesses, necrotizing fasciitis, and Lemierre's syndrome were most common.
• Males (70%) and patients over 40 (49%) were disproportionately affected; overall mortality was 10%.
• Key bacteria included viridans group streptococci, beta-hemolytic streptococci, F. necrophorum, S. aureus, Prevotella, and Bacteroides.

Conclusions:

• Clinicians must recognize the diverse spectrum of PTA complications.
• Males and older adults face higher risks.
• Viridans group streptococci, S. aureus, Prevotella, and Bacteroides are implicated alongside Group A streptococci and F. necrophorum.