Corticosteroids and peritonsillar abscess formation in infectious mononucleosis.
Peritonsillar abscess formation is an uncommon complication of infectious mononucleosis (IM). Early case reports implicated corticosteroids in the development of such abscesses, however, subsequent studies suggested that these drugs do not promote the formation of abscesses at several sites outside the central nervous system. It has recently been demonstrated that zwitterionic polysaccharides, in bacterial capsules, form complexes with CD4(+) T lymphocytes leading to abscess formation. A patient is presented who developed peritonsillar abscess a few days after initiation of corticosteroid therapy for IM; the medical literature was reviewed in respect of this subject. It appears that the occurrence of these abscesses in IM is not strongly linked to corticosteroid treatment. The authors, therefore, recommend that steroids should not be withheld from patients with severe IM on the basis that they may precipitate the development of peritonsillar abscess.
Department of ENT, Craigavon Area Hospital, 68 Lurgan Road, Craigavon, N. Ireland. Barney@doctors.org.uk
Brendan C
BC
Hanna
Ronan
R
McMullan
Samuel J
SJ
Hall
D000284:Administration, Oral; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002444:Cefuroxime / Q000008:administration & dosage; D003907:Dexamethasone / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007244:Infectious Mononucleosis / Q000188:drug therapy*; D000039:Peritonsillar Abscess / Q000139:chemically induced*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D003907:Dexamethasone; D002444:Cefuroxime