Microbiologia dos abscessos peritonsilares

Abstract

Aim: The objective of the present study was to analyze the microbiology of peritonsillar abscesses. Methods: Thirty patients, mean age 24,2 years, with peritonsillar abscesses underwent aspiration of at least 3 mL of pus, which was cultured for aerobes and anaerobes. Results: 87% samples showed positive cultures. Aerobic or facultative aerobic bacteria were isolated from 23% aspirates, mixed aerobic and anaerobic bacteria from 60%, and anaerobic bacteria from only 3% aspirate. A total of 69 bacterial isolates (34 aerobic and 35 anaerobic) were recovered. The most common aerobic isolate was Streptococcus sp, with Streptococcus pyogenes being identified in 23% of aspirates. The predominant anaerobic isolates were Prevotella sp and Peptostreptococcus sp. Patients had received previous antimicrobial therapy in 63% cases. In this group, 1.8 isolates per specimen were recovered, a lower number than in the untreated group (3.0 per specimen). No significant difference in the species isolated was observed between these two groups. Conclusion: Peritonsillar abscess is usually a polymicrobial infection, with predominance of anaerobic bacteria. The number of agents isolated was larger in patients not previously treated with antibiotics, but the use of antimicrobial drugs did not interfere with the type of bacterium isolated.

Use of bacteriologic studies in the management of peritonsillar abscess

“…Most cases of PTA have a polymicrobial infection 1 . Commonly found organisms include Streptococci, anaerobes and staphylococci.…”

“…There are no UK or international guidelines regarding sending PTA aspirates for culture nor as to the antibiotic treatment. It is common practise to start patients empirically on a penicillin prior to culture being obtained 1 . Cheruki reported that by the time culture reports were available, most patients were clinically improved and treatment was not changed 4 …”

Otosclerose

“…A imediata incisão e drenagem é o tratamento de escolha, pois complicações graves decorrentes de abscessos peritonsilares são observados em prontossocorros (SAKAE et al, 2006).…”