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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES & RELATED

EMERGENCY MEDICINE DAY: May 27

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viernes, 28 de diciembre de 2018

Peritonsillar Abscess

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Emergency Medicine News 2018; 40: (12): 8-9
doi: 10.1097/01.EEM.0000550365.44330.de
"A patient with an infection or a collection of pus in the peritonsillar area is rather common in the ED. The process can be cellulitis or a distinct peritonsillar abscess (PTA), also called a quinsy. The infection is characterized by severe sore throat, painful swallowing, fever, drooling, tender adenopathy, muffled voice, and sometimes trismus.
It may be clinically difficult to differentiate between cellulitis and abscess initially. (“Distinguishing Peritonsillar Abscess from Cellulitis,” 2018;40[11]:12; http://bit.ly/EMN-InFocus.) The treatment for an abscess consists of draining the pus, which can be done by needle aspiration or incision and drainage (I&D). Both interventions can be performed in the ED, but most emergency clinicians prefer to do only a needle aspiration. A formal I&D is eschewed because it is somewhat complex and more difficult. Cellulitis is treated with antibiotics, but may progress to an abscess.
The medical literature has compared clinical results from aspiration with I&D for the past 30 years, and numerous articles have attempted to determine the preferred method. The most recent comparison appeared in the Cochrane Database of Systematic Reviews to attempt, unsuccessfully, to assess the effectiveness of one compared with the other intervention..."