title: Four cases of acute epiglottitis with a peritonsillar abscess.
abstract: We report four cases of acute epiglottitis with a peritonsillar abscess originating from the inferior pole of the palatine tonsil. All cases were male, and presented with acute onset of sore throat and dysphagia. Flexible laryngoscopy revealed swollen epiglottis and swelling at the base of tongue along the edge of the epiglottis in all cases. Computed tomography (CT) revealed the position and extent of a peritonsillar abscess. Surgical drainage was not performed. Abscesses decreased in size following intravenous antibiotics and corticosteroids. We surmise that inflammatory exudates extending widely in the pre-epiglottic space cause epiglottic swelling from oropharyngeal infection, the latter of which is thought to produce a peritonsillar abscess. We recommend CT examination for patients with a stable airway and swollen epiglottis, even if the swelling is mild. This will allow for exclusion of deep neck abscess and determination of the most effective treatment including intravenous antibiotics against anaerobe, incision and drainage of an abscess.
authors.affiliation: Department of Otorhinolaryngology, Kumamoto Central Hospital, 955 Muro, Ozu-machi, Kikuchigun, Kumamoto 869-1235, Japan. k-ito@kchosp.or.jp
authors.forename: Keiko
authors.initials: K
authors.lastname: Ito
authors.forename: Hiroko
authors.initials: H
authors.lastname: Chitose
authors.forename: Masamichi
authors.initials: M
authors.lastname: Koganemaru
mesh_terms: D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004826:Epiglottitis / Q000175:diagnosis*; D006801:Humans; D007262:Infusions, Intravenous; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D000039:Peritonsillar Abscess / Q000175:diagnosis*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy; D013297:Streptococcus pyogenes; D014057:Tomography, X-Ray Computed
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents