RT Journal Article
SR Electronic
T1 Peritonsillar abscess may not always be a complication of acute tonsillitis: A prospective cohort study
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 2020.01.09.900068
DO 10.1101/2020.01.09.900068
A1 Sanmark, Enni
A1 Wikstén, Johanna
A1 Välimaa, Hannamari
A1 Aaltonen, Leena-Maija
A1 Ilmarinen, Taru
A1 Blomgren, Karin
YR 2020
UL http://biorxiv.org/content/early/2020/01/09/2020.01.09.900068.abstract
AB The present study aimed to specify diagnostics for peritonsillar abscesses (PTAs) and to clarify the role of minor salivary glands. This prospective cohort study included 112 patients with acute tonsillitis (AT) and PTA recruited at a tertiary hospital emergency department between February and October 2017. All patients completed a questionnaire concerning their current disease. Serum amylase (S-Amyl) and C-reactive protein (S-CRP) levels, tonsillar findings, and pus aspirate samples and throat cultures were analyzed. Eight of 58 PTA patients (13.8%) had no signs of tonsillar infection. The absence of tonsillar erythema and exudate was associated with low S-CRP (p<0.001) and older age (p<0.001). We also observed an inverse correlation between S-Amyl and S-CRP levels (AT, r= −0.519; PTA, r= −0.353). Therefore, we observed a group of PTA patients without signs of tonsillar infection who had significantly lower S-CRP levels than other PTA patients. These findings support that PTA may be caused by an etiology other than AT. Variations in the S-Amyl levels and a negative correlation between S-Amyl and S-CRP levels may indicate that minor salivary glands are involved in PTA development.LEVEL OF EVIDENCE 1b(PTA)Peritonsillar abscess(AT)acute tonsillitis(GAS)Group A streptococcus(FN)Fusobacterium necrophorum(SAG)Streptococcus anginosus group(ID)incision and drainage