Peritonsillar abscess natural history, complications and prognosis: Difference between revisions

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==Overview==
==Overview==
Peritonsillar abscess if left untreated may result in extraperitonsillar extension.<ref name="pmid25255362">{{cite journal| author=Coughlin AM, Baugh RF, Pine HS| title=Lingual tonsil abscess with parapharyngeal extension: a case report. | journal=Ear Nose Throat J | year= 2014 | volume= 93 | issue= 9 | pages= E7-8 | pmid=25255362 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25255362  }} </ref><ref name="pmid26591220">{{cite journal| author=Deeva YV| title=[SURGICAL TREATMENT OF TONSILLAR NECK PHLEGMON]. | journal=Klin Khir | year= 2015 | volume=  | issue= 7 | pages= 47-8 | pmid=26591220 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26591220  }} </ref> Peritonsillar abscess may be complicated by
[[airway obstruction]], [[aspiration]] [[pneumonitis]] or [[lung abscess]] secondary to peritonsillar abscess [[rupture]], [[hemorrhage]] from erosion or [[septic]] [[necrosis]] into [[carotid]] sheath, [[mediastinitis]], poststreptococcal sequelae (e.g., [[glomerulonephritis]], [[rheumatic fever]]) when infection is caused by [[Group A streptococcus]], and [[necrotizing fasciitis]]<ref name="pmid18246890">{{cite journal| author=Galioto NJ| title=Peritonsillar abscess. | journal=Am Fam Physician | year= 2008 | volume= 77 | issue= 2 | pages= 199-202 | pmid=18246890 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18246890  }} </ref><ref name="pmid9231089">{{cite journal| author=Goldenberg D, Golz A, Joachims HZ| title=Retropharyngeal abscess: a clinical review. | journal=J Laryngol Otol | year= 1997 | volume= 111 | issue= 6 | pages= 546-50 | pmid=9231089 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9231089  }} </ref><ref name="pmid2355414">{{cite journal| author=Stevens HE| title=Vascular complication of neck space infection: case report and literature review. | journal=J Otolaryngol | year= 1990 | volume= 19 | issue= 3 | pages= 206-10 | pmid=2355414 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2355414  }} </ref><ref name="pmid7857015">{{cite journal| author=Greinwald JH, Wilson JF, Haggerty PG| title=Peritonsillar abscess: an unlikely cause of necrotizing fasciitis. | journal=Ann Otol Rhinol Laryngol | year= 1995 | volume= 104 | issue= 2 | pages= 133-7 | pmid=7857015 | doi=10.1177/000348949510400209 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7857015  }} </ref><ref name="pmid6594557">{{cite journal| author=Wenig BL, Shikowitz MJ, Abramson AL| title=Necrotizing fasciitis as a lethal complication of peritonsillar abscess. | journal=Laryngoscope | year= 1984 | volume= 94 | issue= 12 Pt 1 | pages= 1576-9 | pmid=6594557 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6594557  }} </ref> The prognosis of peritonsillar abscess is good with early and appropriate treatment.<ref name="pmid22321140">{{cite journal| author=Powell J, Wilson JA| title=An evidence-based review of peritonsillar abscess. | journal=Clin Otolaryngol | year= 2012 | volume= 37 | issue= 2 | pages= 136-45 | pmid=22321140 | doi=10.1111/j.1749-4486.2012.02452.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22321140  }} </ref><ref name="pmid7782170">{{cite journal| author=Apostolopoulos NJ, Nikolopoulos TP, Bairamis TN| title=Peritonsillar abscess in children. Is incision and drainage an effective management? | journal=Int J Pediatr Otorhinolaryngol | year= 1995 | volume= 31 | issue= 2-3 | pages= 129-35 | pmid=7782170 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7782170  }} </ref><ref name="pmid12646835">{{cite journal| author=Johnson RF, Stewart MG, Wright CC| title=An evidence-based review of the treatment of peritonsillar abscess. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 3 | pages= 332-43 | pmid=12646835 | doi=10.1067/mhn.2003.93 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12646835  }} </ref><ref name="pmid7630308">{{cite journal| author=Herzon FS| title=Harris P. Mosher Award thesis. Peritonsillar abscess: incidence, current management practices, and a proposal for treatment guidelines. | journal=Laryngoscope | year= 1995 | volume= 105 | issue= 8 Pt 3 Suppl 74 | pages= 1-17 | pmid=7630308 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7630308  }} </ref>


==Natural history, complications and prognosis==
==Natural history, complications and prognosis==
===Natural history===
Peritonsillar abscess if left untreated may result in extraperitonsillar extension.<ref name="pmid25255362">{{cite journal| author=Coughlin AM, Baugh RF, Pine HS| title=Lingual tonsil abscess with parapharyngeal extension: a case report. | journal=Ear Nose Throat J | year= 2014 | volume= 93 | issue= 9 | pages= E7-8 | pmid=25255362 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25255362  }} </ref><ref name="pmid26591220">{{cite journal| author=Deeva YV| title=[SURGICAL TREATMENT OF TONSILLAR NECK PHLEGMON]. | journal=Klin Khir | year= 2015 | volume=  | issue= 7 | pages= 47-8 | pmid=26591220 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26591220  }} </ref>
===Complications===
The following are some complications that may follow peritonsillar abscess:<ref name="pmid18246890">{{cite journal| author=Galioto NJ| title=Peritonsillar abscess. | journal=Am Fam Physician | year= 2008 | volume= 77 | issue= 2 | pages= 199-202 | pmid=18246890 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18246890  }} </ref><ref name="pmid9231089">{{cite journal| author=Goldenberg D, Golz A, Joachims HZ| title=Retropharyngeal abscess: a clinical review. | journal=J Laryngol Otol | year= 1997 | volume= 111 | issue= 6 | pages= 546-50 | pmid=9231089 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9231089  }} </ref><ref name="pmid2355414">{{cite journal| author=Stevens HE| title=Vascular complication of neck space infection: case report and literature review. | journal=J Otolaryngol | year= 1990 | volume= 19 | issue= 3 | pages= 206-10 | pmid=2355414 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2355414  }} </ref><ref name="pmid7857015">{{cite journal| author=Greinwald JH, Wilson JF, Haggerty PG| title=Peritonsillar abscess: an unlikely cause of necrotizing fasciitis. | journal=Ann Otol Rhinol Laryngol | year= 1995 | volume= 104 | issue= 2 | pages= 133-7 | pmid=7857015 | doi=10.1177/000348949510400209 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7857015  }} </ref><ref name="pmid6594557">{{cite journal| author=Wenig BL, Shikowitz MJ, Abramson AL| title=Necrotizing fasciitis as a lethal complication of peritonsillar abscess. | journal=Laryngoscope | year= 1984 | volume= 94 | issue= 12 Pt 1 | pages= 1576-9 | pmid=6594557 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6594557  }} </ref>
*Extraperitonsillar spread example [[Parapharyngeal space infection|parapharyngeal]] extension, deep neck tissues and [[posterior]] [[mediastinum]]<ref name="pmid25255362">{{cite journal| author=Coughlin AM, Baugh RF, Pine HS| title=Lingual tonsil abscess with parapharyngeal extension: a case report. | journal=Ear Nose Throat J | year= 2014 | volume= 93 | issue= 9 | pages= E7-8 | pmid=25255362 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25255362  }} </ref><ref name="pmid26591220">{{cite journal| author=Deeva YV| title=[SURGICAL TREATMENT OF TONSILLAR NECK PHLEGMON]. | journal=Klin Khir | year= 2015 | volume=  | issue= 7 | pages= 47-8 | pmid=26591220 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26591220  }} </ref><ref name="pmid26527518">{{cite journal| author=Kawabata M, Umakoshi M, Makise T, Miyashita K, Harada M, Nagano H et al.| title=Clinical classification of peritonsillar abscess based on CT and indications for immediate abscess tonsillectomy. | journal=Auris Nasus Larynx | year= 2016 | volume= 43 | issue= 2 | pages= 182-6 | pmid=26527518 | doi=10.1016/j.anl.2015.09.014 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26527518  }} </ref>
:*Peritonsillar abscess may spread through the [[deep fascia]] of the neck with associated rapid progression to a more serious infection.
*[[Airway obstruction]]
*[[Aspiration]] [[pneumonitis]] or [[lung abscess]] secondary to peritonsillar abscess [[rupture]]
*[[Hemorrhage]] from erosion or [[septic]] [[necrosis]] into [[carotid]] sheath
*[[Mediastinitis]]
*Poststreptococcal sequelae (e.g., [[glomerulonephritis]], [[rheumatic fever]]) when infection is caused by [[Group A streptococcus]]
*[[Necrotizing fasciitis]]
===Prognosis===
The prognosis of peritonsillar abscess is good with early and appropriate treatment.<ref name="pmid22321140">{{cite journal| author=Powell J, Wilson JA| title=An evidence-based review of peritonsillar abscess. | journal=Clin Otolaryngol | year= 2012 | volume= 37 | issue= 2 | pages= 136-45 | pmid=22321140 | doi=10.1111/j.1749-4486.2012.02452.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22321140  }} </ref><ref name="pmid7782170">{{cite journal| author=Apostolopoulos NJ, Nikolopoulos TP, Bairamis TN| title=Peritonsillar abscess in children. Is incision and drainage an effective management? | journal=Int J Pediatr Otorhinolaryngol | year= 1995 | volume= 31 | issue= 2-3 | pages= 129-35 | pmid=7782170 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7782170  }} </ref><ref name="pmid12646835">{{cite journal| author=Johnson RF, Stewart MG, Wright CC| title=An evidence-based review of the treatment of peritonsillar abscess. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 3 | pages= 332-43 | pmid=12646835 | doi=10.1067/mhn.2003.93 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12646835  }} </ref><ref name="pmid7630308">{{cite journal| author=Herzon FS| title=Harris P. Mosher Award thesis. Peritonsillar abscess: incidence, current management practices, and a proposal for treatment guidelines. | journal=Laryngoscope | year= 1995 | volume= 105 | issue= 8 Pt 3 Suppl 74 | pages= 1-17 | pmid=7630308 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7630308  }} </ref>


==References==
==References==

Latest revision as of 17:25, 3 March 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]

Overview

Peritonsillar abscess if left untreated may result in extraperitonsillar extension.[1][2] Peritonsillar abscess may be complicated by airway obstruction, aspiration pneumonitis or lung abscess secondary to peritonsillar abscess rupture, hemorrhage from erosion or septic necrosis into carotid sheath, mediastinitis, poststreptococcal sequelae (e.g., glomerulonephritis, rheumatic fever) when infection is caused by Group A streptococcus, and necrotizing fasciitis[3][4][5][6][7] The prognosis of peritonsillar abscess is good with early and appropriate treatment.[8][9][10][11]

Natural history, complications and prognosis

Natural history

Peritonsillar abscess if left untreated may result in extraperitonsillar extension.[1][2]

Complications

The following are some complications that may follow peritonsillar abscess:[3][4][5][6][7]

  • Peritonsillar abscess may spread through the deep fascia of the neck with associated rapid progression to a more serious infection.

Prognosis

The prognosis of peritonsillar abscess is good with early and appropriate treatment.[8][9][10][11]

References

  1. ↑ 1.0 1.1 1.2 Coughlin AM, Baugh RF, Pine HS (2014). "Lingual tonsil abscess with parapharyngeal extension: a case report". Ear Nose Throat J. 93 (9): E7–8. PMID 25255362.
  2. ↑ 2.0 2.1 2.2 Deeva YV (2015). "[SURGICAL TREATMENT OF TONSILLAR NECK PHLEGMON]". Klin Khir (7): 47–8. PMID 26591220.
  3. ↑ 3.0 3.1 Galioto NJ (2008). "Peritonsillar abscess". Am Fam Physician. 77 (2): 199–202. PMID 18246890.
  4. ↑ 4.0 4.1 Goldenberg D, Golz A, Joachims HZ (1997). "Retropharyngeal abscess: a clinical review". J Laryngol Otol. 111 (6): 546–50. PMID 9231089.
  5. ↑ 5.0 5.1 Stevens HE (1990). "Vascular complication of neck space infection: case report and literature review". J Otolaryngol. 19 (3): 206–10. PMID 2355414.
  6. ↑ 6.0 6.1 Greinwald JH, Wilson JF, Haggerty PG (1995). "Peritonsillar abscess: an unlikely cause of necrotizing fasciitis". Ann Otol Rhinol Laryngol. 104 (2): 133–7. doi:10.1177/000348949510400209. PMID 7857015.
  7. ↑ 7.0 7.1 Wenig BL, Shikowitz MJ, Abramson AL (1984). "Necrotizing fasciitis as a lethal complication of peritonsillar abscess". Laryngoscope. 94 (12 Pt 1): 1576–9. PMID 6594557.
  8. ↑ 8.0 8.1 Powell J, Wilson JA (2012). "An evidence-based review of peritonsillar abscess". Clin Otolaryngol. 37 (2): 136–45. doi:10.1111/j.1749-4486.2012.02452.x. PMID 22321140.
  9. ↑ 9.0 9.1 Apostolopoulos NJ, Nikolopoulos TP, Bairamis TN (1995). "Peritonsillar abscess in children. Is incision and drainage an effective management?". Int J Pediatr Otorhinolaryngol. 31 (2–3): 129–35. PMID 7782170.
  10. ↑ 10.0 10.1 Johnson RF, Stewart MG, Wright CC (2003). "An evidence-based review of the treatment of peritonsillar abscess". Otolaryngol Head Neck Surg. 128 (3): 332–43. doi:10.1067/mhn.2003.93. PMID 12646835.
  11. ↑ 11.0 11.1 Herzon FS (1995). "Harris P. Mosher Award thesis. Peritonsillar abscess: incidence, current management practices, and a proposal for treatment guidelines". Laryngoscope. 105 (8 Pt 3 Suppl 74): 1–17. PMID 7630308.
  12. ↑ Kawabata M, Umakoshi M, Makise T, Miyashita K, Harada M, Nagano H; et al. (2016). "Clinical classification of peritonsillar abscess based on CT and indications for immediate abscess tonsillectomy". Auris Nasus Larynx. 43 (2): 182–6. doi:10.1016/j.anl.2015.09.014. PMID 26527518.

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