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Recurrent Peritonsillar Abscess Caused by Vaginal Flora: A Common Problem From a Unique Source

Kelly C Landeen1, Nicole G DeSisto1, Mary Kate Jordan2

  • 1Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.

Ear, Nose, & Throat Journal
|April 22, 2024
PubMed

Insights

Recurrent peritonsillar abscesses (PTAs) can result from Gardnerella vaginalis superinfection. Prompt identification and targeted antibiotic therapy, including coverage for G. vaginalis, are crucial for resolving persistent PTAs.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Microbiology

Background:

  • Peritonsillar abscesses (PTAs) are commonly caused by Group A Streptococcus or mixed oral flora.
  • Gardnerella vaginalis, a bacterium associated with bacterial vaginosis, is not a typical cause of PTAs.
  • This case report details a rare instance of recurrent PTA linked to G. vaginalis superinfection.

Purpose of the Study:

  • To report a unique case of recurrent peritonsillar abscesses (PTAs).
  • To highlight the role of Gardnerella vaginalis as a causative agent in a superinfected PTA.
  • To emphasize the importance of appropriate culturing and targeted antibiotic therapy for persistent or recurrent PTAs.

Main Methods:

  • Case presentation of a patient with recurrent peritonsillar abscesses.
  • Identification of Gardnerella vaginalis in PTA aspirate cultures.
  • Modification of antibiotic regimen to include coverage for G. vaginalis.

Main Results:

  • The patient experienced recurrent PTAs following an initial infection.
  • Gardnerella vaginalis was identified as a superinfecting organism after oral-genital contact.
  • Broadened antibiotic coverage targeting both Group A Streptococcus and G. vaginalis successfully resolved the recurrent infections.

Conclusions:

  • Culturing PTA aspirate is essential for guiding antibiotic treatment in persistent or recurrent cases.
  • Gardnerella vaginalis can cause rare superinfections in peritonsillar abscesses.
  • The findings suggest a potential need for counseling on sexual practices post-oral procedures to prevent superinfection.
Keywords:
computed tomographyhead and neckotolaryngologypediatrics

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