Patients with comorbid rheumatoid arthritis are predisposed to peritonsillar abscess: real-world evidence

Ding, Meng-Chang; Tsai, Ming‐Shao; Liu, Chia‐Yen; Tsai, Yao‐Te; Hsu, Cheng‐Ming; Wu, Ching‐Yuan; Chang, Pey‐Jium; Lin, Kuo-Jen; Chang, Geng‐He

doi:10.1007/s00405-021-06638-3

Cited by 6 publications

(3 citation statements)

References 35 publications

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“…Wu et al found a link between diabetes mellitus type 2 and an increased risk of PTA [18]. Ding et al note that PTA is more prevalent in patients with rheumatoid arthritis during 5 years of diagnosis [19]. Our data indicate that individuals with comorbidities are at an increased risk of developing complications; hence, they should be treated as inpatients, and oral antibiotics should be chosen for adults without systemic disorders.…”

Section: Discussionmentioning

confidence: 57%

Ubi pus, ibi evacua: a review of 601 peritonsillar abscess adult cases

et al. 2021

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Background Peritonsillar abscess (PTA) is the most common deep neck infection, occurring as a consequence of bacterial acute tonsillitis or as a result of infection of the Weber glands, with frequent and life-threatening complications. Aim To investigate several factors associated with complications and worse prognosis, such as defining the method of surgical drainage and treatment of a PTA which remains an area of controversy in the literature Methods The purpose of this retrospective study is to examine the epidemiological, clinical, and laboratory findings of 601 adult patients and to discuss them along with their treatment plan. Results Pharyngalgia was the most common reported symptom, followed by trismus, odynophagia, fever, hot potato voice, malaise, and cervical lymphadenopathy. Sixty-eight patients developed complications. Streptococcus species were the most common pathogens. A statistically significant difference was found in days of hospitalization, WBC and CRP levels, age, and the pre-existing systemic diseases between patients with and without complications. A comparison of patients treated with intravenous and oral antibiotics revealed no statistically significant difference. Conclusion Οver 10% of PTA cases may develop complications, the most common of which is extension into deep neck spaces. Comorbid conditions increase the risk of complications. Despite the wide range of treatment strategies, incision and drainage remain the cornerstone of surgical treatment. In patients with no comorbidities, intravenous antibiotics appear to have no advantage over oral antibiotics.

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Section: Discussionmentioning

confidence: 57%

Ubi pus, ibi evacua: a review of 601 peritonsillar abscess adult cases

et al. 2021

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“…Reported risk factors for developing PTA are smoking, diabetes mellitus, end‐stage renal disease, and rheumatoid arthritis 3–6 . The reported recurrence rates of PTA range from 5% to 22% 7–12 .…”

Section: Introductionmentioning

confidence: 99%

“…2 Reported risk factors for developing PTA are smoking, diabetes mellitus, end-stage renal disease, and rheumatoid arthritis. [3][4][5][6] The reported recurrence rates of PTA range from 5% to 22%. [7][8][9][10][11][12] Previous studies have identified younger age (<30 years or <40 years) and recurrent tonsillitis as risk factors for PTA recurrence.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Recurrence of Peritonsillar Abscess

et al. 2022

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Objectives: This study aimed to investigate the risk factors associated with peritonsillar abscess (PTA) recurrence in adult patients.Methods: This retrospective cohort study used a nationwide insurance claims database in Japan. Adult patients (aged ≥ 20 years) who received intravenous antibiotics or surgical therapy within 5 days of their first PTA diagnosis were included. Multivariable Cox proportional modeling was used to investigate the risk factors for PTA recurrence using the variables: age, sex, comorbidities, tobacco use, history of recurrent tonsillitis, duration of intravenous antibiotics, and surgical therapy for PTA.Results: This study included 12,012 patients (8784 men, 73.1%). Of them, 1358 (11.3%) experienced PTA recurrence. An age ≥40 years and treatment with intravenous antibiotics for 3 days or more were associated with a lower risk of PTA recurrence (aged ≥ 40 years: adjusted hazard ratio [HR]: 0.69; 95% confidence interval [CI]: 0.62-0.78, treated with intravenous antibiotics for 3 days or more: adjusted HR: 0.85; 95% CI: 0.76-0.96). Patients with a history of recurrent tonsillitis were associated with a higher risk of recurrence (adjusted HR: 1.79; 95% CI: 1.47-2.19). Conclusion:A median age of 20-39 years, a history of recurrent tonsillitis, and less than 3 days of intravenous antibiotic therapy may be risk factors for PTA recurrence among adult patients. Further studies exploring more detailed clinical data are necessary to confirm the risk factors for PTA recurrence.

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