Peritonsillar abscess
also see Retropharyngeal abscess

Pathophysiology

• Potential space between superior constrictor m. & tonsil
• Tonsillo/pharyngitisprogresses from cellulitisto abscess
• Purulence collection intonsillar fossa
• Tonsillarandperitonsillaredema may compromise airway
• remember: “peri-teen-sillar” abscesses occur in teenagers

Etiology:

• GABHS
• Anaerobic bacteria
• Less commonly, Staphylococcusaureus

Therapy:

• Antibiotics
• Penicillin
• Clindamycin
• Cefazolin
• Unasyn
• OTO/HNS consult
• Drainage with tonsillectomy if no response to antibiotics in 24-48 hours
• Tonsillectomy indicated if recurrent or severeperitonsillarabscess

Retropharyngeal vs Peritonsillar

• R: < 6 yo, P: Teens
• R: fever, sore throat, neck stiffness
• P: fever, sore throat, trismus
• R: purulence of retropharyngeal LN
• P: purulence in tonsillar fossa
• R: may need imaging
• P: PE diagnostic

CHLA Board Review 2005