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Peritonsillar abscess associated with infectious mononucleosis
E Arkkila1, J Sipilä, E Laurikainen
1Department of Otorhinolaryngology, University Central Hospital, Turku, Finland.
Abstract:
Infectious mononucleosis (IM) is characterized as a viral disease; thus, no antibiotic treatment is recommended. However, some of these patients tend to develop a long-lasting, painful disease, which can be relieved by antibiotic administration. Due to this bed-side knowledge, we re-evaluated 928 patients with peritonsillar abscess (PA), treated during a 5.5-year period in the Department of Otorhinolarygology of Turku University Central Hospital. Of these patients 15 (1.6%) also had infectious mononucleosis (IM). During this period, 64 patients with severe pharyngeal IM were treated in our department and thus the proportion of PA in patients with IM was 23.4%. A control of 15 age- and sex-matched patients with PA but without mononucleosis was formed in order to evaluate the possible differences in patient history, clinical symptoms and findings. Such differences were small and did not affect the chosen treatment of PA, abscess tonsillectomy. There was no peri- or postoperative difference in complications or recovery, but the hospitalization time was longer in IM patients with PA (3.1 days) than in patients with PA only (2.4 days). IM patients referred to ENT departments make a special group of patients, who may also need surgical treatment.
Insights
Infectious mononucleosis (IM) patients with peritonsillar abscess (PA) experienced longer hospital stays. Despite differences, PA treatment, including tonsillectomy, remained consistent for IM and non-IM patients.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Virology
Background:
- Infectious mononucleosis (IM), a viral illness, typically does not warrant antibiotic treatment.
- Some IM patients develop persistent, painful symptoms potentially responsive to antibiotics.
- Peritonsillar abscess (PA) is a common complication treated in ENT departments.
Purpose of the Study:
- To investigate the prevalence and characteristics of peritonsillar abscess (PA) in patients with infectious mononucleosis (IM).
- To compare clinical presentations, treatment outcomes, and hospitalization times between PA patients with and without IM.
- To assess if IM influences the management and recovery of PA.
Main Methods:
- Retrospective analysis of 928 patients with PA treated over 5.5 years.
- Identification of 15 patients (1.6%) with co-existing IM and PA.
- Formation of a control group of 15 age- and sex-matched PA patients without IM.
- Comparison of patient history, clinical findings, treatment, complications, and recovery.
Main Results:
- The proportion of PA among severe pharyngeal IM patients was 23.4%.
- Clinical differences between IM+PA and PA-only groups were minor and did not alter PA treatment (abscess tonsillectomy).
- Hospitalization was longer for IM+PA patients (3.1 days) compared to PA-only patients (2.4 days).
- No significant peri- or postoperative complications or recovery differences were observed.
Conclusions:
- Patients with IM and PA represent a distinct group requiring ENT surgical intervention.
- While IM does not alter PA treatment strategy, it is associated with extended hospitalization.
- Further research may clarify the underlying reasons for prolonged recovery in IM patients with PA.