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Clinical and Microbiologic Aspects and Treatment Regimens

Seppo Savolainen, MD, PhD; Hannele R. Jousimies-Somer, PhD; Antti A. Mäkitie, MD; Jukka S. Ylikoski, MD, PhD

Arch Otolaryngol Head Neck Surg. 1993;119(5):521-524.

Abstract
• This prospective study shows that acute peritonsillar abscess can be successfully treated by three-point puncture and aspiration. The results (recurrence in 19%) are comparable with published data on drainage of the peritonsillar space through the incision procedure. By proper selection of patients, the rate of recurrences can be further reduced. Because the occurrence of Streptococcus pyogenes in the aspirate seems to be associated with a favorable prognosis of therapy with puncture and antibiotics only, testing for the presence of this bacterial species might give a useful clue to the type of treatment needed. If the bacterial culture shows mixed aerobic and anaerobic flora, but not S pyogenes, and if the patient has a history of recurrent tonsillitis, incision or proceeding directly to tonsillectomy may be the best therapeutical choice.

(Arch Otolaryngol Head Neck Surg. 1993;119:521-524)

Author Affiliations
From the Department of Otolaryngology, Central Military Hospital, Helsinki, Finland (Drs Savolainen and Mäkitie); the Anaerobe Reference Laboratory, National Public Health Institute, Helsinki (Dr Jousimies-Somer); and the Department of Otolaryngology, University of Kuopio (Finland) (Dr Ylikoski).

Footnotes
Accepted for publication September 15, 1992.

Reprint requests to Department of Otolaryngology, Central Military Hospital, Box 50, SF-00301 Helsinki, Finland (Dr Savolainen).

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