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

Lookup NU author(s): Jason PowellORCiD, Emerita Professor Janet WilsonORCiD


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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.

Publication metadata

Author(s): Powell EL, Powell J, Samuel JR, Wilson JA

Publication type: Article

Publication status: Published

Journal: Journal of Antimicrobial Chemotherapy

Year: 2013

Volume: 68

Issue: 9

Pages: 1941-1950

Print publication date: 23/04/2013

ISSN (print): 0305-7453

ISSN (electronic): 1460-2091

Publisher: Oxford University Press


DOI: 10.1093/jac/dkt128


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