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Otorinolaringologia 2020 Nov 03

DOI: 10.23736/S0392-6621.20.02281-X

Copyright © 2020 EDIZIONI MINERVA MEDICA

Peritonsillar and Parapharyngeal abscess: a prospective, non-randomized, single center study

José M. PALACIOS-GARCÍA , Emilio DOMINGUEZ-DURÁN, Serafín SÁNCHEZ-GÓMEZ

Department of Otorhilaryngology and Head and Neck Surgery, University Hospital Virgen Macarena, Seville, Spain


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BACKGROUND: Deep neck infection continue to be frequent pathology in otolaryngology emergencies. However, the etiologies of these processes are only partially defined. Sometimes, peritonsillar abscess (PTA) and parapharyngeal abscess (PPA) can be difficult to differentiate. Our aim is to reveal the clinical differences between PTA and PPA.
METHODS: An observational prospective study was carried out on patients who had PTA or PPA in a tertiary referral hospital between December 2015 to May 2019. The following clinical features were analyzed and compared: age, gender, admission date, clinical features, comorbidities, blood test, antibiotic treatment, complications, needed of surgery, pus culture result, seasonal impact and hospitalization admission days.
RESULTS: 103 patients met the inclusion criteria. 59 (57,3%) were men and 44 (42,7%) were female, the mean age was 36,40 ± 16,86 years (min: 5/max:90). PTA was the most common with 87 (84,47%) cases and PPA was 16 (15,53%) cases. Patients with PPA had a regular alcohol intake and a bad oral hygiene, finding significant differences p = 0.001 and p = 0.004 respectively. In addition, 25% of patients with PPA were diabetic compared to 2.3% of the PTA group p = 0.005. 59.77% of patients with PTA had already started antibiotic treatment before they came to the hospital. In the PPA group only had started antibiotic 31.25% of patients. Streptococcus anginosus group was the microorganisms more frequent isolated 30 (32.61%) cases followed by Oropharyngeal flora with 25 (27.16%) cases.
CONCLUSIONS: Diabetes mellitus, alcohol intake and a poor oral hygiene are risk factor frequent to develop PPA. Streptococcus anginosus (milleri) spp presents a high rate of resistance to clindamycin.


KEY WORDS: Deep neck infection; Peritonsillar abscess; Parapharyngeal abscess; Streptococcus anginosus

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