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Excerpt from Peritonsillar Abscess


Synonyms, Key Words, and Related Terms: peritonsillar abscess, head and neck infection, peritonsillar space, PTA, quinsy, peritonsillar cellulitis, retropharyngeal abscess

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Background

Peritonsillar abscess (PTA) is a common infection of the head and neck region. Combinations of aerobic and anaerobic bacteria colonize the peritonsillar space. This potential space is bounded by the tonsillar pillars anteroposteriorly, the piriform fossa inferiorly, and the hard palate superiorly.

Pathophysiology

Peritonsillar abscess is an infection that begins superficially and progresses into the deep soft tissues. The exact mechanism of the initial abscess formation is not known. Abscesses form between the palatine tonsil and its capsule, usually at the superior pole. It is believed that these abscesses most likely arise from an acute episode of tonsillitis, which then progresses to involve the soft tissues surrounding this area. Another proposed mechanism is necrosis and pus formation in the capsular area, which then obstructs the weber glands, which then swell, and the abscess forms.

Frequency

United States

According to Herzon, peritonsillar abscess is the most common infection of the peritonsillar region.1 In the United States, the incidence is somewhere around 30 cases per 100,000 persons per year, accounting for approximately 45,000 cases annually.

International

A higher rate due to recurrence and antibiotic resistance is reported internationally.

Mortality/Morbidity

  • The death rate of peritonsillar abscess is unknown.
  • Morbidity of peritonsillar abscess is due mostly to pain, cost of treatment, lost time from work and school, and complications.

Race

No racial predilection of peritonsillar abscess is noted.

Sex

The male-to-female ratio of peritonsillar abscess is equal.

Age

Peritonsillar abscess can occur in anyone aged 10-60 years according to one source, although peritonsillar abscess is most commonly seen in those aged 20-40 years.1 The younger children who get peritonsillar abscess often are immunocompromised.

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