PERITONSILLAR ABSCESS
 
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PERITONSILLAR ABSCESS

 

DEFINITION:

A complication of acute pharyngotonsillitis resulting in a purulent space-occupying lesion around the tonsils.

EPIDEMIOLOGY:

  • incidence: ?
  • age of onset:
    • preadolescence -> adolescence
  • risk factors:
    • acute pharyngotonsillitis

PATHOGENESIS:

1. Pathogens

  • 1. Group A Streptococcus
  • 2. Oral Anaerobes

    • 2. Pathogenesis

    • this abscess occurs as a complication of acute pharyngotonsillitis and develops in the space between the tonsil and the superior constrictor muscle

    CLINICAL FEATURES:

    1. Prodrome

    • acute pharyngotonsillitis
    • fever

    2. Symptoms

    • severe throat pain -> refuses to speak or swallow (drooling)
    • trismus (spasm of pterygoid muscles)
    • torticollis (ipsilateral neck muscles)
    • fever (40.5 C)

    3. Signs

    • erythema and edema of affected area -> fluctuant
    • uvula displaced to contralateral side

    MANAGEMENT:

    1. Medical

    • Penicillin V 25 mg/kg/d PO/IV tid x 10 days

    2. Surgical

    • incision and drainage or aspiration
    • tonsillectomy (if prior history of abscess or tonsillitis)
    • 10% recurrence rate

     

     

     

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