Twists and Turns of Peritonsillar Abscess

Twists and Turns of Peritonsillar Abscess

Objectıve: The presence of untreated pus within the peritonsillar space can herald the occurrence of various clinical scenarios that could be difficult to describe. In this article we discuss the “TWISTS AND TURNS OF PERITONSILLAR ABSCESS” we have met in the Northwestern region of Nigeria that have not yet been reported in the literature and to compare the means of symptom duration at presentation among study groups. Materıal and Methods: It is a retrospective study. A total number of 25 patients formed the study population (N) and were classified into three: Group 1 included patients who presented early with peritonsillar Abscess and had expected clinical course following treatment. Group 2 included patients who presented late and thus had one twist or the other from the usual presentation. Group 3 included patients who died. Results: The mean age = 24 ± 11 years. Sore throat, dysphagia and fever were the most common symptoms. Asymmetrically enlarged tonsil was the most common oropharyngeal finding with occasionally occurring twists and turns such as gangrenous tonsil, auto-tonsillectomy, and severely bleeding tonsil. Conclusıon: Peritonsillar abscess (PTA) constitutes a relentless infection that needs urgent, adequate treatment based on acceptable methods, delay in presentation can herald the occurrence of pathologies that could be difficult to interpret.

___

  • 1. Gupta G, McDowell RH. Peritonsillar Abscess. In: StatPearls. Statpearls Publishing, Treasure Island (FL); 2022. PMID 30137805
  • 2. Scott P. Stringer, Steven D. Schaefer, Lanny G. Close. A randomized Trial of outpatient management of peritonsillar Abscess. Arch Otolaryngol Head Neck Surg 1988; 114: 296-298
  • 3. Waheed A.A, Gabriel T.O, Aluko A. A. Clinial profile and Management of Peritonsillar Abscess in Sub Saharan Africa. International Journal of Innovative Research in Medical Science (IJIRMS). 2020;5 (1): 5-9
  • 4. Olusola A.S, Emmanuel A. O. Management of Peritonsillar Abscess in A tertiary Hospital in Southwest Nigeria. Ann Afr Surg. 2022; 19 (2): 68-72
  • 5. Maharaj D, Rajah V, Hemsley S. Management of peritonsillar abscess. The Journal of Laryngology and Otology. 1991; 105: 743-745
  • 6. Tejs Ehlers K, Maria Rusan, Kurt Fuursted, Therese Ovesen. Pertonsillar Abscess; Complication of Acute Tonsillitis or Weber’s glands Infection? Otolaryngology-Head and Neck Surgery. 2016; 155 (2): 199-207
  • 7. Klug, T.E., Greve, T. & Hentze, M. Complications of peritonsillar abscess. Ann Clin Microbiol Antimicrob 19, 32 (2020). https://doi.org/10.1186/s12941-020-00375-x
  • 8. Stanley B Amutta, Mohammed Abdullahi, Daniel Aliyu, Joshua C Okoro. Peritonsillar abscess: Pattern and treatment intervention in a tertiary health institution in Sokoto metropolis. International Journal of Medical and Health Research. 2018; 4 (10): 149-152
  • 9. Kodiya AM, Ngamdu YB, Sandabe BM, Isa A, Garadawa HI. Management Strategies of Peritonsillar Abscess in the Tropics: A Survey of Surgeons’ preference. Indian J Otolaryngol Head Neck Surg. 2014 Jun; 66 (2): 127-30. doi: 10.1007/s12070-012-0540-7
  • 10. Freire, G., Dos Santos, J., Rolón, P., Pinheiro, G., & Sampaio, A. (2017). Peritonsillar abscess: Epidemiology and relationship with climate variations. The Journal of Laryngology & Otology, 131(7), 627-630. doi:10.1017/S0022215117000895
  • 11. Windfuhr, J.P., Zurawski, A. Peritonsillar abscess: remember to always think twice. Eur Arch Otorhinolaryngol 273, 1269–1281 (2016). https://doi.org/10.1007/s00405-015-3582-0
  • 12. Wang Y-P, Wang M-C, Lin H-C, Chou P (2014) The Impact of Prior Tonsillitis and Treatment Modality on the Recurrence of Peritonsillar Abscess: A Nationwide Cohort Study. PLoS ONE 9(10): e109887. https://doi.org/10.1371/journal.pone.0109887
  • 13. Olushola Abdulrahman AFOLABI, Alli ABDULLAHI, Abimiku Soloman LABARAN et al. Peritonsillar Abscess in Northern Nigeria: A 7 Year Review. Malays J Med Sci. 2014 nov- Dec; 21(6): 14-18
  • 14. Vitor Passy MD. Pathogenesis of peritonsillar abscess. The Laryngoscope. 1994; 104(2): 1185-190 https://doi.org/10.1288/00005537-199402000-00011
  • 15. Salinger S, Pearman SJ. Hemorrhage from pharyngeal and Peritonsillar Abscess: Report of the cases , Résumé of the literature and discussion of ligation of the carotid artery. Arch Otolaryngol. 1933;18(4):464–509. doi:10.1001/archotol.1933.03580060496006
  • 16. Watanabe T, Suzuki M. Bilateral Peritonsillar Abscesses: Our Experience and Clinical Features. Annals of Otology, Rhinology & Laryngology. 2010;119(10):662-666. doi:10.1177/000348941011901003
  • 17. Nurdogan Ata, MD. Giant Fistula of the Peritonsillar Abscess. Ear, Nose & Throat Journal.2019; 98(3):126–127. DOI: 10.1177/0145561319836598