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Tonsillar Abscess

Abscess Intratonsillar


Presentation

  • Abstract This article presents seven cases of patients with tonsillar abscess formation and discusses the pathophysiology of intratonsillar abscess formation.[ncbi.nlm.nih.gov]
  • A 19-year-old woman presented to the emergency department with a 10-day history of intermittent odynophagia, voice changes, and fever.[nejm.org]
  • Peritonsillar abscess (ReelDx Lecture) Presentation ReelDx Lecture Pearls Diagnosis Treatment 47-year-old with pharyngitis and difficulty swallowing ( watch video ) Patient will present as a 19-year-old male who you are seeing for follow-up from the urgent[smartypance.com]
  • If no abscess is present , the antibiotic usually starts to clear the infection within 48 hours. If a peritonsillar abscess is present , a doctor must insert a needle in it or cut into it to drain the pus.[merckmanuals.com]
  • Patients presenting symptomatology will be recorded (e.g. trismus, dysarthria, dysphagia, documented fever, etc).[clinicaltrials.gov]
Falling
  • […] hoarse voice congestion or popping of the.Antihistamines Antihistamines relieve the itching sneezing and runny. color in nature; frequency of discharge is severe; itching in nose and eyes; sensation of obstruction in throat Every holiday season I tend to fall[cedag.eu]
  • […] the benefits of treating sore throats with antibiotics was moderate and that many patients would need to be treated to prevent one case of quinsy. [ 22 ] The number needed to treat (NNT) was estimated by a Canadian study as being about 30. [ 23 ] A fall[patient.info]
  • 1 and whether “an intervention can be recommended as a cost effective use of NHS resources”. 1 However, they can only assess a limited number of treatments each year; for example the HTBS will assess 10 interventions in 2001–02. 17 It will therefore fall[pmj.bmj.com]
Stridor
  • Stridor is a late sign Consider direct laryngoscopy if any concern. Aspirate that pus! We rarely admit paratonsilar abscesses. Usually ENT/the ED aspirates them, they get better and go home. Ultrasound can increase the yield of aspiration.[ucsfmed.wordpress.com]
  • Patients younger than 4 years old present more frequently with agitation, cough, drooling, lethargy, respiratory distress, rhinorrhea, and stridor and less frequently with positive physical signs on oropharyngeal examination and trismus compared with[clinicaladvisor.com]
Tonsillar Mass
  • Quinsy abscess Needle aspiration: All such patients require needle aspiration of the tonsillar mass and cultures. Aspiration of pus differentiates abscess from cellulitis.[smartypance.com]
Constipation
  • Since her Jan she has lost 4 stone and has no appetite, she gets tummy cramps, alternates between diahorea (sorry about spelling) and constipation, she has piles and lost her taste.[healthquestions.medhelp.org]
Halitosis
  • […] and severity of recurrent Otitis, pharyngitis, PT abscess Unresponsive to antibiotics Snoring Poor appetite or slow weight gain Halitosis No evidence that routine elective tonsillectomy prevents future PTA Diagnostic testing Usually not necessary CBC[fprmed.com]
  • Other common symptoms include a "hot potato" voice (speaking as if a hot object is in the mouth), drooling, redness of the tonsils, white patches (exudates), swollen lymph nodes in the neck, and severe bad breath (halitosis).[merckmanuals.com]
  • […] includes : Sore throat Difficulty swallowing Painful swallowing Trismus – pain and difficulty when opening mouth Muffled voice, also described as a “hot potato” voice Excessive salivation and drooling Tonsil swelling is more one one side Bad breath (halitosis[healthhype.com]
Bleeding Gums
  • By removing the plaque correctly you lower the chances of ever suffering from gingivitis, bleeding gums, and periodontal disease.[covingtonsmiles.com]
Tachycardia
  • Dysphagia Neck pain/swelling Due to lymphadenopathy Jugulodigastric area of affected side Physical examination Fever, tachycardia, dehydration Throat/pharynx exam Swollen and fluctuant tonsil with Uvula deviation AWAY from abscess side Tonsil displaced[fprmed.com]
Thrombosis
  • Adenitis Salivary gland infections Leukemia or Lymphoma Complications Airway obstruction Cellulitis of the jaw, neck, or chest Necrotizing Fascitis Endocarditis, Pericarditis, Mediastinitis Pleural effusion Aspiration Pneumonia Internal Jugular Vein thrombosis[pedclerk.bsd.uchicago.edu]

Workup

Excessive Drooling
  • Clinical features include a unilateral odynophagia, dysphagia , voice changes (sometimes classically referred to as a ‘hot potato’ voice), trismus, and excessive drooling 5. Additionally, patients may be systemically unwell with fever and malaise 5.[radiopaedia.org]

Treatment

  • Although this case had a successful outcome, many patients do not survive, particularly if treatment is delayed or inadequate.[ncbi.nlm.nih.gov]
  • Secondly, it allows assessment (including effectiveness and opportunity costs) of new or alternative treatments, and comparison with the existing prevalent treatment. 1– 3 Thirdly, it highlights areas of treatment requiring further research.[pmj.bmj.com]
  • This can be done with: Ultrasound CT scan MRI scan Treatment Talk with your doctor about the best treatment plan for you. Treatment may include: Supportive care Rest and drink plenty of fluids.[cancercarewny.com]
  • Links: clinical features treatment General Practice Notebook General Practice Notebook The information provided herein should not be used for diagnosis or treatment of any medical condition.[gpnotebook.co.uk]
  • Such differences were small and did not affect the chosen treatment of PA, abscess tonsillectomy.[ncbi.nlm.nih.gov]

Prognosis

  • , Prevention, and Complications Prognosis very good to excellent with early diagnosis and treatment Prevention identification and treatment of tonsillits before it progresses to abscess Complications respiratory obstruction, difficulty swallowing Please[medbullets.com]
  • Doppler probe pressure may elicit movement of the debris within the abscess heterogeneous, poorly defined margins may also demonstrate surrounding hyperechoic rim color flow or power Doppler may demonstrate circumferential hyperemia 8 Treatment and prognosis[radiopaedia.org]
  • . • Sepsis • Pneumonia • Airway obstruction • Cellulitis Treatment of Peri-tonsillar Abscess • Antibiotics • Needle Aspiration • Incision and drainage Prognosis of Peri-tonsillar Abscess Peritonsillar abscess gets cured with proper treatment Diet / management[drthindhomeopathy.com]
  • Prognosis After treatment, the outlook is usually excellent. Peritonsillar abscess can come back, however.[drugs.com]
  • Death can occur from aspiration, airway obstruction, erosion into major blood vessels or extension to the mediastinum. [ 7 ] Prognosis The rate of recurrence is poorly defined but is around 9-22%. [ 20 ] Recurrence can follow tonsillectomy but is rare[patient.info]

Etiology

  • Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10data.com]
  • Peritonsillar abscess is usually a complication of tonsillitis and thus has a similar clinical presentation and infective etiology 4.[radiopaedia.org]
  • Etiology Often progresses from exudative tonsillitis- tonsillar cellulitis- abscess Usually bacterial and polymicrobial with an over-representation of GAS, s milleri and anaerobes esp fusobacterium.[ucsfmed.wordpress.com]
  • Are also known etiologies. It is more rare in preschool age children, as the lymph tissue is predominantly located in the retro pharynx, thus accounting for the prevalence of retropharyngeal abscesses. Most cases in pediatrics will be seen in teens.[pemcincinnati.com]
  • Abscess (PTA) Weber's glands inflammation worsens to tissue necrosis & pus formation near the superior pole of tonsil (also midpoint/inferior pole) Collection of pus between the fibrous tonsillar capsule & superior pharyngeal constrictor muscle forms Etiology[fprmed.com]

Epidemiology

  • 24th June 2011, Volume 124 Number 1336 Emily Macassey, Patrick J D Dawes Article Authors References In this issue of the NZMJ, Love et al 1 report interesting observations about patterns of epidemiology and microbiology of peritonsillar abscess (PTA)[nzma.org.nz]
  • Epidemiology Annual incidence is 30/100,000 people with a peak onset during adolescence By contrast, appendicitis has an incidence of 233/100,000 people.[ucsfmed.wordpress.com]
  • Pertinent epidemiological data will be collected from the emergency room consultation note dictated by the treating physician and stored in a separate database. In the microbiology laboratory, the fluid aspirate will undergo aerobic culture.[clinicaltrials.gov]
  • Tonsillitis, Pharyngitis Epidemiology Sore throat is a common complaint in children and adolescents. Most cases of pharyngitis are viral and self-limited.[pedsinreview.aappublications.org]
  • Epidemiology In the US, there are 30 per 100,000 persons years (45,000 cases annually). Most infections occur during November to December and April to May, coinciding with the highest incidence of streptococcus pharyngitis and exudative tonsilitis.[pedclerk.bsd.uchicago.edu]
Sex distribution
Age distribution

Pathophysiology

  • Abstract This article presents seven cases of patients with tonsillar abscess formation and discusses the pathophysiology of intratonsillar abscess formation.[ncbi.nlm.nih.gov]
  • Quinsy Pathophysiology Tonsillitis is a common infection of tissue in the throat. It is mainly caused by bacteria.[healthhype.com]
  • […] infection (50%) Most common in aged 20-40 yrs 10–18 y old (most) 6 mo–5 y old (rare) Younger children w/ peritonsillar abscess- often immunocompromised Yearly occurrence coincides w/ rates of strep pharyngitis & exudative tonsillitis Nov-Dec & April-May Pathophysiology[fprmed.com]
  • Tonsillitis is inflammation of the pharyngeal tonsils (see separate article Tonsillitis ). [ 1 ] In peritonsillar abscess, there is pus trapped between the tonsillar capsule and the lateral pharyngeal wall. [ 2 ] Pathophysiology It usually starts with[patient.info]

Prevention

  • Prevention Tonsillitis should be diagnosed and treated as soon as possible to help prevent a peritonsillar abscess from developing. Treatment Your doctor will prescribe antibiotics to treat the infection.[drugs.com]
  • , and Complications Prognosis very good to excellent with early diagnosis and treatment Prevention identification and treatment of tonsillits before it progresses to abscess Complications respiratory obstruction, difficulty swallowing Please rate topic[medbullets.com]
  • You are not preventing gingivitis and periodontal disease, but also peritonsillar abscesses.[covingtonsmiles.com]
  • Surgery to remove the tonsils (tonsillectomy) may be advised to prevent recurrence of peritonsillar abscess, but the operation is usually delayed until the infected abscess has subsided.[healthcommunities.com]
  • Preventing tonsillitis The best way to prevent tonsillitis is to avoid close contact with people who have the viral or bacterial infections that cause the condition.[your.md]

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