A review of the pathogenesis of adult peritonsillar abscess: time for a re-evaluation

Powell, E; Powell, Jason; Samuël, Julie; Wilson, Janet A.

doi:10.1093/jac/dkt128

Cited by 80 publications

(115 citation statements)

References 80 publications

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“…Moreover, we did not find a significant seasonal variation in PTA incidence. These data, when compared with the significant peaks in acute tonsillitis during the cold seasons, again reconfirms the above-reported hypothesis that PTA pathogenesis is more complex than a simple diffusion of the infection from the tonsils to the peritonsillar spaces [2,6,7,39]. A possible bias in our data might concern any hypothetical migration of patients from the Veneto to undergo surgery elsewhere, but this possibility is probably very remote, given the generally high quality of the Veneto's health system and the straightforward nature of this surgical procedure.…”

Section: Discussionsupporting

confidence: 85%

“…One would have expected an overlap between these ranges of age, if PTA was indeed a direct complication of AT [2,7]. Moreover, we did not find a significant seasonal variation in PTA incidence.…”

Section: Discussionmentioning

confidence: 42%

“…Our data demonstrated that the annual incidence of PTA hospital admission in the Veneto region (9.13/100,000 in the general population) has remained stable in the considered period and was slightly lower with respect to the range reported in the literature (10-41/100,000) [1,2]. On the other hand, the tonsillectomy rate has been declining from 115/100,000 in 1997 to 64.7 in 2006 [17].…”

Section: Discussionmentioning

confidence: 69%

“…Peritonsillar abscess (PTA) is the most common deep neck space infection and a problem frequently encountered by otolaryngologists, with an incidence ranging from 10 to 41/100,000 [1,2]. Etiopathogenesis of PTA is still controversial.…”

Section: Introductionmentioning

confidence: 99%

“…There seem to be two pathogenically different PTA subtypes, one caused by a single organism, most often group A Streptococcus; the second polymicrobial, due to a variety of facultative and obligate anaerobes and probably representative of a chronic underlying microfloral imbalance. In patients aged 15-24 and in the elderly, Fusobacterium necrophorum is the prevalent pathogen [1][2][3][4] and its growth from PTA aspirates correlates with a higher rate of recurrence, and may serve as an additional relative indicator for tonsillectomy [2,4,5].…”

Section: Introductionmentioning

confidence: 99%

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Hospital discharge survey on 4,199 peritonsillar abscesses in the Veneto region: what is the risk of recurrence and complications without tonsillectomy?

Bovo

Barillari

2015

Eur Arch Otorhinolaryngol

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The Veneto region's database of hospital discharge records was queried for ICD-9 codes corresponding to: peritonsillar abscess (PTA), PTA incision and drainage, tonsillectomy, pharyngeal-retropharyngeal abscess, cervical phlegmon, cervical abscess, and mediastinitis recorded from 1997 to 2006. All these codes were considered to identify cases of PTA recurrence and severe infectious complications occurring in conservatively treated patients. Among 4,199 patients whose PTA was incised and drained on admission to hospital, 1,532 were treated with tonsillectomy, while 2,667 were treated conservatively (without tonsillectomy). Abscess tonsillectomy was carried out almost exclusively in children (0-14 years of age), and only in 40 young and adult patients (0.95 %). The relapse rate after a single episode of PTA was 11.7 %, while potentially fatal complication occurred in 0.41 % of cases. Incidence of PTA hospital admission has remained stable in the considered period despite a 45 % reduction in the tonsillectomy rate. In conclusion, our data seem to show that conservative treatment for PTA is not associated with a significant risk of recurrence (and becomes minimal after 6-12 months), provided that patients have not suffered from previous PTA episodes.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 42%

Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Hospital discharge survey on 4,199 peritonsillar abscesses in the Veneto region: what is the risk of recurrence and complications without tonsillectomy?

Bovo

Barillari

2015

Eur Arch Otorhinolaryngol

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What antibiotic should be used in the management of an otherwise healthy adult with a peritonsillar abscess?

2017

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Smoking and Alcohol Consumption Are Associated With the Increased Risk of Peritonsillar Abscess

2020

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Objectives/Hypothesis: The purpose of this study was to evaluate the relationship among smoking, alcohol consumption, and peritonsillar abscess in a Korean population. Study Design: Individuals ≥40 years old from the Korean National Health Insurance Service-Health Screening Cohort were assessed from 2002 to 2013. Methods: In total, 1,285 peritonsillar abscess participants were matched with 5,140 controls at a ratio of 1:4 with respect to age group, sex, income group, region of residence, hypertension, diabetes, and dyslipidemia. We analyzed the participants' previous histories of smoking (current smokers vs. nonsmokers or past smokers) and alcohol consumption (drinkers vs. nondrinkers) in the peritonsillar abscess and control groups. Peritonsillar abscess was defined using the International Classification of Disease-10 code J36 combined with claim codes for incision and drainage or aspiration. Crude and adjusted odds ratios (ORs) were analyzed using unconditional logistic regression analyses, and 95% confidence intervals (CI) were calculated. Results: The rates of smoking and consuming alcohol were higher in the peritonsillar abscess group than in the control group. The adjusted OR of smoking for peritonsillar abscess was 1.23 (95% CI = 1.06-1.44, P = .009), and that of alcohol consumption was 1.18 (95% CI = 1.02-1.36, P = .024). Conclusion: The odds of smoking and alcohol consumption were increased in peritonsillar abscess patients compared to those in the control group.

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A review of the pathogenesis of adult peritonsillar abscess: time for a re-evaluation

Cited by 80 publications

References 80 publications

Hospital discharge survey on 4,199 peritonsillar abscesses in the Veneto region: what is the risk of recurrence and complications without tonsillectomy?

Hospital discharge survey on 4,199 peritonsillar abscesses in the Veneto region: what is the risk of recurrence and complications without tonsillectomy?

What antibiotic should be used in the management of an otherwise healthy adult with a peritonsillar abscess?

Smoking and Alcohol Consumption Are Associated With the Increased Risk of Peritonsillar Abscess

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