Significant pathogens in peritonsillar abscesses

Abstract

Purpose: Peritonsillar abscesses (PTA) are polymicrobial infections, with a diverse aerobic and anaerobic flora. The aim of the present study is to compare bacteriologic culture results from patients with PTA to those from patients undergoing elective tonsillectomy (clinically non-infected tonsils), to better elucidate the pathogenic significance of various isolates. Methods: A prospective study was conducted on 36 PTA patients undergoing acute tonsillectomy and on 80 electively tonsillectomized patients. Results: Fusobacterium necrophorum (FN) and Streptococcus Group A (GAS) were isolated significantly more frequently from the tonsillar cores of PTA patients, both from the abscessed (P=0.001 and P=0.046, respectively) and non-abscessed side (P<0.001 and P=0.046, respectively), than from the tonsillar cores of electively tonsillectomized patients. Conclusions:Our findings indicate that FN and GAS are the prominent pathogens in PTA. In patients with PTA the incidence of FN and GAS isolated from the abscessed tonsil was the same as from the non-abscessed contralateral side, and the growth was comparable by a semi-quantitative approach. Our findings suggest that FN is also of pathogenic importance in acute tonsillitis, and that FN growth is not a subsequent phenomenon once an abscess has formed. Our findings further suggest that other factors influence the development of PTA.

Clinical and biochemical characteristics of patients with Fusobacterium necrophorum-positive acute tonsillitis

“…Previous studies from our institution have documented that FN is the predominant pathogen in peritonsillar abscesses, which is the most frequent complication of acute tonsillitis [8,10]. Other studies indicate that FN may also play a role in acute tonsillitis [3,11,12].…”

“…Recent studies from our institution document that FN is also the most prevalent pathogen in peritonsillar abscess development [8,10]. Both Lemierre's syndrome and peritonsillar abscess are complications of acute tonsillitis and it is therefore likely that FN can also be of pathogenic importance in uncomplicated acute tonsillitis.…”

Microbial Flora and Antibiotic Resistance in Peritonsillar Abscesses in Upstate New York

“…1,3-9 Powell et al 3 argue that there may be 2 distinct pathophysiologies in peritonsillar abscesses. [1][2][3]5,[10][11][12]14 This may be because not all specimens in our study were sent for anaerobic specific cultures, especially if the patient's abscess was drained at the bedside. 3 In contrast, polymicrobial peritonsillar abscesses may arise when there are cases of imbalance in the natural oral flora, permitting the bacteria to interact with each other in a synergistic manner to cause a peritonsillar abscess.…”

Quinsy in Adult: Clinical Profile and Management Challenges in Two Tertiary Hospitals Northwest Nigeria

“…Other authors prefer to use Penicillins as their first line [23]. We rather use Ceftriaxone because we are concerned about immunologic complications of GAS, and will want a drug that can clear it as much as possible [1,3,15,17,18]. Immunologic complications of GAS are not much of a problem is some developed countries as it is in our environment [23].…”

“…This theory best explains the epidemiology and aetiopathogenesis of PTA. Microbiology of PTA is polymicrobial, but in some instances may be monomicrobial [1,15,17,18]. Group A Streptococci (GAS), and Fusobacterium Necrophorum are common organisms isolated from aspirates of patients [1,3,18,19].…”