[Management of peritonsillar infections].
| Autor: | García Callejo FJ; Servicio de Otorrinolaringología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, España. jgarciacall@hotmail.com, Núñez Gómez F, Sala Franco J, Marco Algarra J |
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| Jazyk: | Spanish; Castilian |
| Zdroj: | Anales de pediatria (Barcelona, Spain : 2003) [An Pediatr (Barc)] 2006 Jul; Vol. 65 (1), pp. 37-43. |
| DOI: | 10.1157/13090896 |
| Abstrakt: | Objective: To evaluate the clinical and epidemiologic characteristics in children with peritonsillar infections. Patients and Methods: A longitudinal retrospective study was performed through a review of the clinical histories of patients attending the emergency unit in the previous 6 years. The variables gathered were age, sex, recurrent tonsillitis, previous upper airway infection, antibiotic administration, and therapeutic approach. Results: Twenty-nine children were admitted, with a mean age of 7.4 +/- 1.6 years (boys 1.6:1). Twenty-seven percent had recurrent tonsillitis. At the visit, 57.8 % had an upper respiratory infection and 65 % were taking antibiotic treatment, especially macrolides. The treatment selected at our center consisted of the association of penicillin or amoxicillin-clavulanate acid with clindamycin, including corticosteroids. Ten children underwent computed tomography and nine underwent fine-needle aspiration. Drainage was performed in 20.6 % of confirmed abscesses. The mean length of hospital stay was 5.6 +/- 1.6 days. Delayed tonsillectomy was performed in 31 %, except in one patient who developed a parapharyngeal abscess. Currently, 18.9 % of all peritonsillar infections occur in the pediatric population. Conclusions: The increase in these infections is probably related to inappropriate use of antibiotics in respiratory diseases. Diagnosis is clinical, and infections are often resolved by intravenous administration of beta-lactams with clindamycin and an expectant attitude. When an abscess is suspected or there is no clinical improvement, fine-needle aspiration or computed tomography is warranted and drainage should be performed if an abscess is confirmed. Tonsillectomy, usually delayed, is only indicated in patients with recurrent tonsillitis. |
| Databáze: | MEDLINE |
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