Costales-Marcos María, López-Álvarez Fernando, Núñez-Batalla Faustino, Moreno-Galindo Carla, Alvarez Marcos César, Llorente-Pendás José Luis
Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Principado de Asturias, España.
Acta Otorrinolaringol Esp. 2012 May-Jun;63(3):212-7. doi: 10.1016/j.otorri.2012.01.001. Epub 2012 Mar 16.
Peritonsillar infection is the most frequent complication of acute tonsillitis. Peritonsillar infections are collections of purulent material, usually located between the tonsillar capsule and the superior constrictor of the pharynx. Peritonsillar infection can be divided into abscess and cellulitis.
We prospectively analysed the clinical data from 100 patients with peritonsillar infection from 2008 to 2010. The diagnosis of abscess or peritonsillar cellulitis was primarily based on obtaining pus through fine-needle aspiration.
Seventy-seven per cent of patients had no history of recurrent tonsillitis and 55% were receiving antibiotic treatment. Sixty-two cases were peritonsillar abscess and the rest were cellulitis. Trismus, uvular deviation and anterior pillar bulging were statistically associated with peritonsillar abscess (P<.005). All patients were admitted to hospital and treated with puncture-drainage, intravenous antibiotics (amoxicillin/clavulanate in 83% of cases) and a single dose of steroids. All patients were discharged on oral antibiotic therapy. The mean length of hospital stay was 3 days and the recurrence rate was 5%.
Due to the absence of clinical practice guidelines, there are different therapeutic protocols. According to our experience, puncture-aspiration and administration of intravenous antibiotics is a safe, effective way to treat these patients. To determine the efficacy and safety of outpatient management, controlled studies would be needed.
扁桃体周围感染是急性扁桃体炎最常见的并发症。扁桃体周围感染是脓性物质的聚集,通常位于扁桃体被膜与咽上缩肌之间。扁桃体周围感染可分为脓肿和蜂窝织炎。
我们前瞻性分析了2008年至2010年100例扁桃体周围感染患者的临床资料。脓肿或扁桃体周围蜂窝织炎的诊断主要基于细针穿刺获取脓液。
77%的患者无复发性扁桃体炎病史,55%的患者正在接受抗生素治疗。62例为扁桃体周围脓肿,其余为蜂窝织炎。牙关紧闭、悬雍垂偏斜和前柱隆起与扁桃体周围脓肿有统计学关联(P<0.005)。所有患者均入院治疗,采用穿刺引流、静脉使用抗生素(83%的病例使用阿莫西林/克拉维酸)和单剂量类固醇治疗。所有患者出院时接受口服抗生素治疗。平均住院时间为3天,复发率为5%。
由于缺乏临床实践指南,存在不同的治疗方案。根据我们的经验,穿刺抽吸和静脉使用抗生素是治疗这些患者的安全、有效方法。为确定门诊治疗的有效性和安全性,需要进行对照研究。