Peritonsillar abscess: treatment with immediate tonsillectomy - 10 years of experience.
CONCLUSIONS
Immediate tonsillectomy in patients with peritonsillar abscess is a safe and effective treatment that should be considered as an alternative to conventional incision and drainage.


OBJECTIVE
To assess the efficacy, safety, and microbiology of immediate tonsillectomy over 10 years, in patients with peritonsillar abscess.


METHODS
This was a retrospective study. We reviewed the clinical charts of patients diagnosed with peritonsillar abscess in Clínica Las Condes from September 2000 to August 2010, who were treated with immediate unilateral or bilateral tonsillectomy. The patients' epidemiological information, antibiotic therapy, laterality of the surgery, results of microbiological cultures, complications, and recurrences were recorded.


RESULTS
A total of 112 patients were studied, with a mean age of 24 years. There were no events of sepsis, and there were only four cases (3.6%) of postoperative bleeding, two of which resolved spontaneously. Only 29% of the patients required morphine pump-based analgesia in the postoperative period. The mean length of hospital stay was 3.4 days. Among the 28 unilateral tonsillectomies, 4 (14.2%) developed streptococcal tonsillitis and 2 (7.1%) were readmitted with a contralateral peritonsillitis: one cellulitis and one abscess that required drainage and tonsillectomy. The most frequently isolated microorganisms were gram-positive bacteria (Streptococcus pyogenes and other streptococci) and anaerobic bacteria (mainly Bacteroides spp. and Fusobacterium nucleatum).
Public Health Department, Clinica Las Condes, University of Chile, Santiago, Chile. nicolas.albertz@gmail.com
Nicolas
N
Albertz
Gonzalo
G
Nazar
D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000503:physiopathology; D000039:Peritonsillar Abscess / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D019106:Postoperative Hemorrhage / Q000503:physiopathology / Q000628:therapy; D012008:Recurrence; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D017751:Safety Management; D012720:Severity of Illness Index; D014068:Tonsillectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
D000701:Analgesics, Opioid