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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.
Archives of Otolaryngology--Head & Neck Surgery
|May 1, 1993
Summary
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.