Szuhay G, Tewfik T L
Department of Otolaryngology, McGill University, Montreal Children's Hospital, Quebec.
J Otolaryngol. 1998 Aug;27(4):206-12.
Peritonsillar sepsis (PTS) can be divided into abscess and cellulitis. It is the most common deep neck infection in the paediatric age group. In this article we discuss the clinical issues related to peritonsillar sepsis in children.
This study involves 185 cases of peritonsillar that were treated at the Montreal Children's Hospital in the last 10 years. The symptoms, signs, laboratory and radiological data as well as the medical and surgical therapies are included.
Seventy-five cases were peritonsillar cellulitis (PTC) and the rest were abscesses. The age at presentation varied between 2.5 months and 18 years. The majority of the cases diagnosed as peritonsillar abscess (PTA) occurred from age 12 to 18 years. Trismus was the only complaint that was statistically associated with PTA. Uvular deviation combined with trismus was also important in differentiating PTA from PTC. Our data revealed a lower percentage of anaerobic bacteria and the majority of cultures grew Streptococcus pyogenes group A.
Clinical picture is important in differentiating PTA from PTC. Recurrence of peritonsillar sepsis was higher in children with a history of recurrent tonsillitis. Needle aspiration of PTA resulted in a higher incidence of recurrence compared to incision and drainage. A management algorithm is suggested for the child presenting with peritonsillar sepsis.
扁桃体周围脓肿（PTS）可分为脓肿型和蜂窝织炎型。它是儿童年龄组中最常见的深部颈部感染。在本文中，我们讨论与儿童扁桃体周围脓肿相关的临床问题。
本研究纳入了过去10年在蒙特利尔儿童医院接受治疗的185例扁桃体周围疾病患者。纳入了症状、体征、实验室和放射学数据以及内科和外科治疗情况。
75例为扁桃体周围蜂窝织炎（PTC），其余为脓肿。发病年龄在2.5个月至18岁之间。大多数被诊断为扁桃体周围脓肿（PTA）的病例发生在12至18岁。牙关紧闭是唯一与PTA有统计学关联的主诉。悬雍垂偏斜合并牙关紧闭在区分PTA和PTC方面也很重要。我们的数据显示厌氧菌比例较低，大多数培养物中生长的是A组化脓性链球菌。
临床表现对于区分PTA和PTC很重要。有复发性扁桃体炎病史的儿童扁桃体周围脓肿复发率较高。与切开引流相比，PTA穿刺抽吸导致的复发率更高。针对出现扁桃体周围脓肿的儿童，建议采用一种管理算法。
