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J Antimicrob Chemother. 2013 Sep;68(9):1941-50. doi: 10.1093/jac/dkt128. Epub 2013 Apr 23.

A review of the pathogenesis of adult peritonsillar abscess: time for a re-evaluation.

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  • 1Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.

Abstract

OBJECTIVES:

To perform a multifactorial exploration of the aetiology of peritonsillar abscess (PTA) in adults, in order to develop greater clinical understanding of the condition and improve management.

DESIGN:

A literature review exploring key pathogens, predisposing host factors and current pathogenic hypotheses.

METHODS:

A PubMed search for articles published between January 1980 and January 2012 using the terms 'peritonsillar abscess AND microbiology', 'peritonsillar abscess AND pathophysiology' and 'peritonsillar abscess AND etiology'.

RESULTS:

Major pathogens in PTA are opportunistic microflora. Group A streptococcal PTA infections present differently from polymicrobial PTA. A number of host factors influence the conditions required for the pathogenesis of PTA.

CONCLUSIONS:

PTA is clinically distinct from acute tonsillitis and occurs in people with a chronic underlying susceptibility. Targeting host factors, including oral hygiene, antibiotic use and smoking, may prevent PTA. Re-education of clinicians concerning the aetiology of PTA is necessary for appropriate disease management.

KEYWORDS:

aetiology; microbiology; quinsy

PMID:
23612569
DOI:
10.1093/jac/dkt128
[PubMed - indexed for MEDLINE]
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