S Ahmed Ali1, Kevin J Kovatch1, Josh Smith2, Emily L Bellile3, John E Hanks1, Paul T Hoff1. 1. Department of Otolaryngology Head & Neck Surgery, Ann Arbor, Michigan, U.S.A. 2. School of Medicine, University of Michigan, Ann Arbor, Michigan, U.S.A. 3. Department of Biostatistics, Michigan Medicine, Ann Arbor, Michigan, U.S.A.
Abstract
OBJECTIVE: Peritonsillar abscess (PTA) is a common infectious complication of pharyngeal infection managed by otolaryngologists and emergency room physicians. Streptococcus and Fusobacterium (e.g., Fusobacterium necrophorum, FN) species are commonly isolated pathogens. The aim of this study was to determine the implication of culture results on abscess recurrence following drainage. METHODS: Single-institution retrospective review of patients treated at the University of Michigan between 2000 and 2017. Demographic and clinical outcome data were analyzed, including treatment details, culture data, and recurrence. RESULTS: One hundred fifty-six of the 990 patients in our study developed recurrence of their abscess (16%). The age ranges most susceptible to recurrence included adolescent (22.9%) and young adult groups (17.1%). Recurrent patients were more likely to have experienced acute progression of symptoms (79% vs. 71%, P = 0.03), trismus (67% vs. 55%, P = 0.006), voice changes (65% vs. 57%, P = 0.04), and dysphagia (72% vs. 61%, P = 0.01) compared to nonrecurrent patients. They were also more likely to have clinical lymphadenopathy noted on initial examination (67% vs. 56%, P = 0.009). Culture data was sent for 852 patients (86%). The presence of FN was significantly more prevalent in the recurrent group (P < 0.0001). CONCLUSION: There is a high observed prevalence of FN species within PTA aspirates in the recurrent PTA population. PTA aspirate should be sent for anaerobic growth to screen for Fusobacterium species. In addition, follow-up and lower threshold for subsequent tonsillectomy should be considered in this at-risk group. LEVEL OF EVIDENCE: 3 Laryngoscope, 129:1567-1571, 2019.
OBJECTIVE:Peritonsillar abscess (PTA) is a common infectious complication of pharyngeal infection managed by otolaryngologists and emergency room physicians. Streptococcus and Fusobacterium (e.g., Fusobacterium necrophorum, FN) species are commonly isolated pathogens. The aim of this study was to determine the implication of culture results on abscess recurrence following drainage. METHODS: Single-institution retrospective review of patients treated at the University of Michigan between 2000 and 2017. Demographic and clinical outcome data were analyzed, including treatment details, culture data, and recurrence. RESULTS: One hundred fifty-six of the 990 patients in our study developed recurrence of their abscess (16%). The age ranges most susceptible to recurrence included adolescent (22.9%) and young adult groups (17.1%). Recurrent patients were more likely to have experienced acute progression of symptoms (79% vs. 71%, P = 0.03), trismus (67% vs. 55%, P = 0.006), voice changes (65% vs. 57%, P = 0.04), and dysphagia (72% vs. 61%, P = 0.01) compared to nonrecurrent patients. They were also more likely to have clinical lymphadenopathy noted on initial examination (67% vs. 56%, P = 0.009). Culture data was sent for 852 patients (86%). The presence of FN was significantly more prevalent in the recurrent group (P < 0.0001). CONCLUSION: There is a high observed prevalence of FN species within PTA aspirates in the recurrent PTA population. PTA aspirate should be sent for anaerobic growth to screen for Fusobacterium species. In addition, follow-up and lower threshold for subsequent tonsillectomy should be considered in this at-risk group. LEVEL OF EVIDENCE: 3 Laryngoscope, 129:1567-1571, 2019.
Authors: T E Klug; J-J Henriksen; M Rusan; K Fuursted; K A Krogfelt; T Ovesen; C Struve Journal: Eur J Clin Microbiol Infect Dis Date: 2014-05-09 Impact factor: 3.267
Authors: E Mazur; E Czerwińska; I Korona-Głowniak; A Grochowalska; M Kozioł-Montewka Journal: Eur J Clin Microbiol Infect Dis Date: 2014-10-17 Impact factor: 3.267