Article in Japanese

Clinical characteristics of peritonsillar abscess in children

Mizuki YANO¹⁾, Kazuhiro UDA^2,3), Junya TSUKAMOTO¹⁾, Kotaro ARAKI^2,3), Kahoru FUKUOKA^2,3), Takahiro MATSUSHIMA¹⁾, Satoko SUZUKI¹⁾, Hiroshi SAKAKIBARA¹⁾, Hiroshi HATAYA¹⁾, Yuho HORIKOSHI^2,3)

Peritonsillar abscess is a serious form of deep-neck bacterial infection. Although early diagnosis and treatment are imperative, few reports have described the detailed clinical course of pediatric peritonsillar abscess in Japan. This study retrospectively reviewed children diagnosed with peritonsillar abscess at this hospital and evaluated the demographic data, clinical symptoms and treatments. Sixteen patients in total were found. Fourteen (88%) had fever, and seven (50%) of them had fever within 48 hours prior to diagnosis. Sixteen (100%), 14 (88%), nine (56%) and eight (50%) patients had sore throat, uvular deviation, trismus and dysphagia, respectively. A rapid antigen test of group A Streptococcus (GAS) was performed in nine patients (56%), and two (22%) of them had positive results. Effective surgical drainage was performed in 11 patients (79%). Microorganisms were detected by rapid antigen test of GAS or culture in 12 patients (75%). GAS, the most frequent pathogen, was detected in six patients (50%) of the 12, followed by Prevotella spp. (four patients, 33%) and Bacteroides spp. (three patients, 25%). Among the positive cases for these microorganisms, eight (67%) of 12 had polymicrobial infection. Ampicillin/sulbactam was administered to all of the patients without treatment failure. Careful observation of symptoms, especially trismus or uvula deviation, is required in children with acute tonsillitis for early diagnosis of peritonsillar abscess, regardless of the preceding fever duration or results of the rapid antigen test for GAS.

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1) Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center
2) Division of Infectious Disease, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center
3) Division of Immunology, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center

Key words	deep neck infection, trismus, uvula deviation, acute tonsillitis
Received	December 10, 2019
Accepted	August 12, 2020

32 (4)：315─323,2020