The microbiology of peritonsillar sepsis

Abstract

Pus obtained by needle aspiration of 91 peritonsillar abscesses was examined microbiologically. A positive culture was obtained in 55 patients (60 per cent). Sixty-four bacteriological isolates were grown. Forty patients had a pure growth of a single organism, of which 21 (53 per cent) were beta Haemolytic streptococci. Pure growths of Staphylococcus aureus were found in only three patients. Fifteen patients had mixed organisms, including anaerobes, in their pus and the resistance to penicillin was low. Only the bacteroides species were generally penicillin resistant. The vast majority of patients made a good recovery following needle drainage of the abscess and treatment with parenteral penicillin. The patients with a mixture of penicillin sensitive and penicillin resistant organisms also made a good clinical recovery following needle drainage and administration of parenteral penicillin. The relevance of these findings in the pathogenesis and management of peritonsillar sepsis is discussed.

The epidemiology of peritonsillar abscess disease in Northern Ireland

“…This is similar to the findings of other studies which were performed using routine hospital processing of specimens. 6,7,12 Needle aspiration of pus from a peritonsillar abscess most frequently yielded a positive culture result, suggesting that this may be the preferred method of specimen collection. This agrees with a study by Hallander et al 13 Throat swabs did not reveal a positive culture in this study except in one patient and this conflicted with a result obtained from culture of the pus.…”

“…Eight reports in the published literature since 1966 (only two from the U.K.) give demographic information applicable to their respective general populations. [1][2][3][4][5][6][7][8] The mean age of occurrence varies from 25 to 32 years. 4,5 Only Herzon has published incidence data; 1 in 6500 of population or 30.1/40 000 person years for the U.S.A. and Puerto Rico.…”

A comparison of procaine penicillin with sulbactam-ampicillin in the treatment of peritonsillar abscesses

“…Thus, the antibiotic chosen for refractory infections must be resistant to β-lactamase enzyme besides being effective on oral microbial flora [1]. Although the growing resistance of strains may limit the use of penicillin, Snow et al [15] found that bacterial resistance to penicillin is still low. As a result, patients having a mixture of penicillin-sensitive and penicillin-resistant organisms also make a good clinical recovery following needle drainage and administration of parenteral penicillin.…”

“…Snow et al [14,15] also indicate that the combination of needle aspirations with parenteral antibiotics is an effective treatment for peritonsillar sepsis, sparing patients the painful experience of an incision and drainage procedure. We believe that incision and drainage are no more unpleasant or painful than needle aspiration and that incision and drainage take only a few seconds to accomplish, whereas needle aspirations may be more time-consuming and require repeat aspirations.…”

Treatment of Peritonsillar Abscess and Role of Steriods

“…5 Our findings are consistent with earlier study where all the patients responded well to the primary empiric antibiotics. Findings of other studies 6,7 have recommended needle aspiration followed by antibiotic as effective treatment for PTA without the need of incision and drainage. Incision and drainage are also reported superior to aspiration followed by antibiotic in relieving pain, in another study.…”