Galioto Nicholas J
Broadlawns Medical Center, Des Moines, IA, USA.
Am Fam Physician. 2017 Apr 15;95(8):501-506.
Peritonsillar abscess is the most common deep infection of the head and neck, occurring primarily in young adults. Diagnosis is usually made on the basis of clinical presentation and examination. Symptoms and findings generally include fever, sore throat, dysphagia, trismus, and a "hot potato" voice. Drainage of the abscess, antibiotic therapy, and supportive therapy for maintaining hydration and pain control are the cornerstones of treatment. Most patients can be managed in the outpatient setting. Peritonsillar abscesses are polymicrobial infections, and antibiotics effective against group A streptococcus and oral anaerobes should be first-line therapy. Corticosteroids may be helpful in reducing symptoms and speeding recovery. Promptly recognizing the infection and initiating therapy are important to avoid potentially serious complications, such as airway obstruction, aspiration, or extension of infection into deep neck tissues. Patients with peritonsillar abscess are usually first encountered in the primary care outpatient setting or in the emergency department. Family physicians with appropriate training and experience can diagnose and treat most patients with peritonsillar abscess.
扁桃体周脓肿是头颈部最常见的深部感染,主要发生于年轻人。诊断通常基于临床表现和检查。症状和体征一般包括发热、咽痛、吞咽困难、牙关紧闭以及“含橄榄”样语音。脓肿引流、抗生素治疗以及维持水合状态和控制疼痛的支持治疗是治疗的基石。大多数患者可在门诊治疗。扁桃体周脓肿是多微生物感染,对A组链球菌和口腔厌氧菌有效的抗生素应作为一线治疗。皮质类固醇可能有助于减轻症状并加速康复。及时识别感染并开始治疗对于避免潜在的严重并发症(如气道阻塞、误吸或感染蔓延至深部颈部组织)很重要。扁桃体周脓肿患者通常首先在基层医疗门诊或急诊科就诊。经过适当培训且有经验的家庭医生可以诊断和治疗大多数扁桃体周脓肿患者。