Peritonsillar abscess natural history, complications and prognosis
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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]
- Extraperitonsillar spread example parapharyngeal extension, deep neck tissues and posterior mediastinum[1][2][12]
- 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.[8][9][10][11]
References
- ↑ 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.
- ↑ 2.0 2.1 2.2 Deeva YV (2015). "[SURGICAL TREATMENT OF TONSILLAR NECK PHLEGMON]". Klin Khir (7): 47–8. PMID 26591220.
- ↑ 3.0 3.1 Galioto NJ (2008). "Peritonsillar abscess". Am Fam Physician. 77 (2): 199–202. PMID 18246890.
- ↑ 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.
- ↑ 5.0 5.1 Stevens HE (1990). "Vascular complication of neck space infection: case report and literature review". J Otolaryngol. 19 (3): 206–10. PMID 2355414.
- ↑ 6.0 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.
- ↑ 7.0 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.
- ↑ 8.0 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.
- ↑ 9.0 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.
- ↑ 10.0 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.
- ↑ 11.0 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.
- ↑ 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.