Related Experiment Videos
Peritonsillar abscess. Clinical and microbiologic aspects and treatment regimens
S Savolainen1, H R Jousimies-Somer, A A Mäkitie
1Department of Otolaryngology, Central Military Hospital, Helsinki, Finland.
Abstract:
This prospective study shows that acute peritonsillar abscess can be successfully treated by three-point puncture and aspiration. The results (recurrence in 19%) are comparable with published data on drainage of the peritonsillar space through the incision procedure. By proper selection of patients, the rate of recurrences can be further reduced. Because the occurrence of Streptococcus pyogenes in the aspirate seems to be associated with a favorable prognosis of therapy with puncture and antibiotics only, testing for the presence of this bacterial species might give a useful clue to the type of treatment needed. If the bacterial culture shows mixed aerobic and anaerobic flora, but not S pyogenes, and if the patient has a history of recurrent tonsillitis, incision or proceeding directly to tonsillectomy may be the best therapeutical choice.
Insights
Acute peritonsillar abscess can be effectively treated with three-point puncture and aspiration. Identifying Streptococcus pyogenes in aspirate may guide treatment, potentially avoiding surgery for some patients.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Surgical Procedures
Background:
- Acute peritonsillar abscess is a common complication of tonsillitis.
- Traditional treatment involves incision and drainage, with varying recurrence rates.
Purpose of the Study:
- To evaluate the efficacy of three-point puncture and aspiration for treating acute peritonsillar abscess.
- To identify predictors of treatment success and recurrence.
Main Methods:
- Prospective study involving patients with acute peritonsillar abscess.
- Treatment administered via three-point puncture and aspiration.
- Bacterial cultures of aspirate analyzed for Streptococcus pyogenes and other flora.
Main Results:
- Three-point puncture and aspiration demonstrated successful treatment outcomes.
- Recurrence rate was 19%, comparable to incision and drainage.
- Presence of Streptococcus pyogenes in aspirate correlated with favorable prognosis for non-surgical management.
Conclusions:
- Three-point puncture and aspiration is a viable treatment option for acute peritonsillar abscess.
- Patient selection and bacterial identification (specifically Streptococcus pyogenes) can optimize treatment strategies.
- In cases of mixed flora without Streptococcus pyogenes and a history of recurrent tonsillitis, incision or tonsillectomy may be preferred.