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Peritonsillar abscess in early childhood. Presentation and management
N R Friedman1, R B Mitchell, K D Pereira
1Le Bonheur Children's Medical Center, Memphis, Tenn, USA.
Objective:
To highlight the modes of presentation and management of a peritonsillar abscess in children younger than 5 years.
Design:
Retrospective case series.
Setting:
Tertiary referral pediatric otolaryngology practice.
Patients:
Seven children younger than 5 years.
Results:
The mean age of the children studied was 27 months (age range, 7-41 months). Five (71%) of the 7 patients underwent computed tomographic scanning to confirm the diagnosis. Pus was cultured at surgery in every case. The most common organism detected was Streptococcus viridans. The average hospital stay was 72 hours (range, 22 hours to 12 days). After diagnosis of an abscess, all patients underwent an electrocautery tonsillectomy and had an uneventful recovery.
Conclusions:
Children younger than 5 years who present with poor oral intake, high fever, drooling, and trismus should be suspected of having a peritonsillar abscess. A computed tomographic scan of the neck is usually required to confirm a suspected diagnosis. Prompt diagnosis and treatment will lead to a considerable decrease in morbidity. Immediate tonsillectomy is a safe and effective means of abscess drainage.