title: Two cases of peritonsillar abscess complicated by von Willebrand disease.
abstract: Von Willebrand disease (vWD) is a common hereditary bleeding disorder resulting from a quantitative and/or qualitative deficiency of von Willebrand factor (vWF). We report two cases of peritonsillar abscess complicated by vWD. A 46-year-old Japanese man was intravenously administered factor VIII clotting antigen (500U×3 days)and platelet transfusion (10U), when before puncture was performed. After puncture, his symptoms promptly improved with the administration of the antibiotic doripenem (DRPM, 1.5g/day). He left our facility one week later and had no recurrence of symptoms. A 24-year-old Japanese woman was intravenously administered factor VIII clotting antigen (4500U×3 days) and desmopressin (DDAVP) before undergoing a puncture. Her symptoms promptly improved with DRPM treatment (1.5g/day). The patient left our facility one week later. However, the peritonsillar abscess recurred in three weeks. Afterwards, tonsillectomy was enforced three months later. Intravenous factor VIII clotting antigen (4500U×2 days) and platelet transfusion (10U×1 day) had been used before tonsillectomy. We therefore suggest that a peritonsillar abscess in patients with vWD can be safely treated by factor VIII clotting antigen and DDAVP at the appropriate disease stage and by performing paracentesis for the acute phase or tonsillectomy for the chronic phase.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, Japan. nagano@m.kufm.kagoshima-u.ac.jp
authors.forename: Hiromi
authors.initials: H
authors.lastname: Nagano
authors.forename: Mizue
authors.initials: M
authors.lastname: Harada
authors.forename: Mizuo
authors.initials: M
authors.lastname: Umakoshi
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Hayamizu
authors.forename: Kosuke
authors.initials: K
authors.lastname: Yoshifuku
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kurono
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015780:Carbapenems / Q000627:therapeutic use; D003029:Coagulants / Q000627:therapeutic use; D000077726:Doripenem; D005169:Factor VIII / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000039:Peritonsillar Abscess / Q000150:complications* / Q000628:therapy*; D014068:Tonsillectomy; D055815:Young Adult; D056728:von Willebrand Disease, Type 2 / Q000150:complications*; D014842:von Willebrand Diseases / Q000150:complications*
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D003029:Coagulants; D005169:Factor VIII; D000077726:Doripenem