Abstract
Introduction: The palatine tonsils represent an important part of the lymphoid tissue in Waldeyer ' s ring. They are positioned in a strategic location in the oropharynx, they are often exposed to both inhaled and ingested antigens and accomplish localized immune functions. This exposure to potential pathogens and involvement in local processing of microorganisms could be the foundation for the high numbers of tonsillar infections. Acute tonsillitis is considered a highly prevalent and expensive condition that affect kids, adolescent and adults. In the US, more than eighteen million patients sought care for acute tonsillitis in 1996, making it the 6th main reason for physician consultations [3]. It is estimated that 4 to 6 times more individuals do not seek medical care for a sore throat. The condition could be even more prevalent in other countries such as Denmark, as about 425,000 rapid streptococcal antigen detection tests (RADT) are done by Danish general practitioners yearly, to diagnose infection with Group A Streptococci (GAS) [VII]. Peritonsillar abscess (PTA), also known as quinsy, refers to a collection of pus located between the tonsillar capsule and the pharyngeal constrictor muscle. It is commonly considered as a complication of acute tonsillitis though some investigators have found evidence pointing to a role of the salivary glands in the soft palate (Weber ' s glands) in the pathogenesis of this condition. Though the prognosis is believed to have been good, serious complications are also reported in the literature over the last three centuies. Recently, lethal outcome of PTA is extremely rare. But, in spite of improvements in living conditions and general health (including oral hygiene), the ease of access to medical care, and the invention and widespread use of antibiotics, PTA is still relatively frequent (approximately 2000 cases annually in Denmark). Aim of work: In this review, we will discuss the management of peritonsillar abscess. Methodology: We did a systematic search for the management of peritonsillar abscess using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). All relevant studies were retrieved and discussed. We only included full articles. Conclusions: The palatine tonsils represent an important part of the lymphoid tissue in Waldeyer ' s ring. They are positioned in a strategic location in the oropharynx, they are often exposed to both inhaled and ingested antigens and accomplish localized immune functions. This exposure to potential pathogens and involvement in local processing of microorganisms could be the foundation for the high numbers of tonsillar infections. Acute tonsillitis is considered a highly prevalent and expensive condition that affect kids, adolescent and adults. We discussed the most recent evidence regarding the management of peritonsillar abscess. The regular history of patients with PTA is 3 to 6 days of progressive sore throat, pain on swallowing to the point of being unable to eat, ear pain, malaise, and trismus. Severe acute tonsillitis involving infectious mononucleosis (IM) have several similar symptoms and findings of PTA involving sore throat, pain on swallowing, ear pain, malaise, discomfort, dehydration, tonsillar exudates, tender and enlarged cervical lymph nodes, and fever. Recently, there are 3 established approaches of draining PTAs: needle aspration, ID, and acute tonsillectomy. Additionally, to surgical drainage, antimicrobial therapy is proposed.
The preferred antibiotic regimen varies between countries and centers. Penicillin, either oral or intraveneous.