Table 1.
Overview of complications to peritonsillar abscesses (PTA)
| Mechanism of propagation and complication | No. of patients | Malesa | Age, median years (range) | Time relation between PTA and complication (time of diagnosis) | Acute tonsillitis prior to PTAa | Antibiotic treatment prior to complicationa | Mortalitya | Sequelaea | |||
|---|---|---|---|---|---|---|---|---|---|---|---|
| PTA prior | Same time | PTA after | Unknown | ||||||||
| Upper airway spread | |||||||||||
| Airway obstruction | 14 | 62% | 17 (0–68) | 1 | 12 | 0 | 1 | 58% | 88% | 7% | 0% |
| Epiglottitis | 15 | 100% | 41 (27–64) | 0 | 5 | 0 | 10 | 80% | 80% | 0% | – |
| Neck tissue spread | |||||||||||
| Para- and retropharyngeal abscess | 96 | 77%b | 62c (14–75) | 2 | 8 | 0 | 86 | 0%d | 50% | 0% | 0% |
| Necrotizing fasciitis | 38 | 76%e | 51 (20–87) | 17 | 6 | 0 | 15 | 22% | 89% | 21% | 46% |
| Mediastinitis | 113 | 65%f | 52 (15–82) | 13 | 13 | 0 | 87 | 41% | 74% | 19% | 38% |
| Internal carotid artery lesion | 7 | 57% | 15 (3–95) | 2 | 5 | 0 | 0 | 33% | 50% | 0% | 50% |
| Parotid gland abscess | 1 | 0% | 60 | 0 | 1 | 0 | 0 | – | 100% | 0% | 0% |
| Mastricator space abscess | 2 | 50% | 83 (75–90) | 2 | 0 | 0 | 0 | 0% | 100% | 0% | – |
| Hematogenous spread | |||||||||||
| Lemierre´s syndrome | 35 | 52% | 21 (0–65) | 2 | 21 | 3 | 9 | 40% | 27% | 10% | 50% |
| Sepsis | 2 | 50% | 10 (0–20) | 0 | 0 | 2 | 0 | 50% | 100% | 0% | 0% |
| Lung infections | 2 | 100% | 38 (14–61) | 1 | 0 | 1 | 0 | 50% | 100% | 0% | 0% |
| Carditis | 3 | 100% | 52 (17–80) | 2 | 0 | 1 | 0 | 50% | 50% | 67% | – |
| Brain abscess | 1 | 0% | 9 | 0 | 1 | 0 | 0 | 100% | 0% | 0% | 100% |
| Septic arthritis | 1 | 100% | 55 | 0 | 1 | 0 | 0 | 100% | 100% | 0% | 100% |
| Immunologic reaction | |||||||||||
| Reactive arthritis | 1 | 0% | 32 | 1 | 0 | 0 | 0 | 100% | 100% | 0% | 0% |
| STSS | 1 | 100% | 68 | 0 | 1 | 0 | 0 | 0% | 0% | 0% | 0% |
| Unknown | |||||||||||
| Kawasakis syndrome | 2 | 100% | 7 (7–7) | 2 | 0 | 0 | 0 | 100% | 100% | 0% | 0% |
| All | 334 | 70%2 | 41 (0-95) | 45 | 74 | 7 | 208 | 42% | 69% | 10% | 21% |
PTA peritonsillar abscess. STSS Streptococcal toxic shock syndrome
aPercentage of cases with information provided (gender: n = 235; acute tonsillitis prior to PTA: n = 98; antibiotic treatment prior to complication: n = 156; mortality: n = 273; sequelae: n = 87)
bp < 0.001, binomial probability test
cn = 5
dn = 4
ep = 0.003, binomial probability test
fp = 0.04, binomial probability test