Pediatric Peritonsillar Abscess Guidelines

1. Pham V, Gungor A. Bilateral peritonsillar abscess: case report and literature review. Am J Otolaryngol. 2012 Jan-Feb. 33(1):163-7. [QxMD MEDLINE Link].

2. Powell J, Wilson JA. An evidence-based review of peritonsillar abscess. Clin Otolaryngol. 2012 Apr. 37(2):136-45. [QxMD MEDLINE Link].

3. Brook I. Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses. J Oral Maxillofac Surg. 2004 Dec. 62(12):1545-50. [QxMD MEDLINE Link].

4. Brook I, Frazier EH, Thompson DH. Aerobic and anaerobic microbiology of peritonsillar abscess. Laryngoscope. 1991 Mar. 101(3):289-92. [QxMD MEDLINE Link].

5. Brook I, Foote PA Jr, Slots J. Immune response to anaerobic bacteria in patients with peritonsillar cellulitis and abscess. Acta Otolaryngol. 1996 Nov. 116(6):888-91. [QxMD MEDLINE Link].

6. Brook I. Role of methicillin-resistant Staphylococcus aureus in head and neck infections. J Laryngol Otol. 2009 Dec. 123(12):1301-7. [QxMD MEDLINE Link].

7. Brook I. Anaerobic bacteria in upper respiratory tract and head and neck infections: microbiology and treatment. Anaerobe. 2012 Apr. 18(2):214-20. [QxMD MEDLINE Link].

8. Risberg S, Engfeldt P, Hugosson S. Peritonsillar abscess and cellulitis and their relation to a positive antigen detection test for streptococcal infection. Scand J Infect Dis. 2010 Oct. 42(10):747-51. [QxMD MEDLINE Link].

9. Brook I. Role of methicillin-resistant Staphylococcus aureus in head and neck infections. J Laryngol Otol. 2009 Dec. 123(12):1301-7. [QxMD MEDLINE Link].

10. Klug TE, Henriksen JJ, Fuursted K, Ovesen T. Significant pathogens in peritonsillar abscesses. Eur J Clin Microbiol Infect Dis. 2011 May. 30(5):619-27. [QxMD MEDLINE Link].

11. Rusan M, Klug TE, Henriksen JJ, Ellermann-Eriksen S, Fuursted K, Ovesen T. The role of viruses in the pathogenesis of peritonsillar abscess. Eur J Clin Microbiol Infect Dis. 2012 Feb 29. [QxMD MEDLINE Link].

12. Brodsky L, Sobie SR, Korwin D, Stanievich JF. A clinical prospective study of peritonsillar abscess in children. Laryngoscope. 1988 Jul. 98(7):780-3. [QxMD MEDLINE Link].

13. Maroldi R, Farina D, Ravanelli M, Lombardi D, Nicolai P. Emergency imaging assessment of deep neck space infections. Semin Ultrasound CT MR. 2012 Oct. 33(5):432-42. [QxMD MEDLINE Link].

14. Brook I. Non-odontogenic abscesses in the head and neck region. Periodontol 2000. 2009 Feb. 49:106-25. [QxMD MEDLINE Link].

15. Ehlers Klug T, Rusan M, Fuursted K, Ovesen T. Fusobacterium necrophorum: most prevalent pathogen in peritonsillar abscess in Denmark. Clin Infect Dis. 2009 Nov 15. 49(10):1467-72. [QxMD MEDLINE Link].

16. D Z Allen 1, K Rawlins 1, A Onwuka 2, C A Elmaraghy 3. Comparison of inpatient versus outpatient management of pediatric peritonsillar abscess outcomes. Int J Pediatr Otorhinolaryngol . 2019. 47-50. [QxMD MEDLINE Link].

17. Millar KR, Johnson DW, Drummond D, Kellner JD. Suspected peritonsillar abscess in children. Pediatr Emerg Care. 2007 Jul. 23(7):431-8. [QxMD MEDLINE Link].

18. Qureshi H, Ference E, Novis S, Pritchett CV, Smith SS, Schroeder JW. Trends in the management of pediatric peritonsillar abscess infections in the U.S., 2000-2009. Int J Pediatr Otorhinolaryngol. 2015 Apr. 79 (4):527-31. [QxMD MEDLINE Link].

19. Sowerby LJ, Hussain Z, Husein M. The epidemiology, antibiotic resistance and post-discharge course of peritonsillar abscesses in London, Ontario. J Otolaryngol Head Neck Surg. 2013 Jan 31. 42:5. [QxMD MEDLINE Link]. [Full Text].

20. Klug TE, Greve T, Hentze M. Complications of peritonsillar abscess. Ann Clin Microbiol Antimicrob. 2020 Jul 30. 19 (1):32. [QxMD MEDLINE Link]. [Full Text].

21. Hidaka H, Kuriyama S, Yano H, Tsuji I, Kobayashi T. Precipitating factors in the pathogenesis of peritonsillar abscess and bacteriological significance of the Streptococcus milleri group. Eur J Clin Microbiol Infect Dis. 2011 Apr. 30(4):527-32. [QxMD MEDLINE Link].

22. Marom T, Cinamon U, Itskoviz D, Roth Y. Changing trends of peritonsillar abscess. Am J Otolaryngol. 2010 May-Jun. 31(3):162-7. [QxMD MEDLINE Link].

23. Hsiao HJ, Huang YC, Hsia SH, Wu CT, Lin JJ. Clinical features of peritonsillar abscess in children. Pediatr Neonatol. 2012 Dec. 53(6):366-70. [QxMD MEDLINE Link].

24. Klug TE, Greve T, Hentze M. Complications of peritonsillar abscess. Ann Clin Microbiol Antimicrob 19(1):32. 2020. 19:32. [QxMD MEDLINE Link].

25. Baker KA, Stuart J, Sykes KJ, Sinclair KA, Wei JL. Use of computed tomography in the emergency department for the diagnosis of pediatric peritonsillar abscess. Pediatr Emerg Care. 2012 Oct. 28(10):962-5. [QxMD MEDLINE Link].

26. Xian Zhao , Gia M Badolato , Joanna S Cohen. Variability in advanced imaging of pediatric neck infections in US emergency departments. Am J Emerg Med . 2022. 10::140-143. [QxMD MEDLINE Link].

27. Fordham MT, Rock AN, Bandarkar A, Preciado D, Levy M, Cohen J, et al. Transcervical ultrasonography in the diagnosis of pediatric peritonsillar abscess. Laryngoscope. 2015 Dec. 125 (12):2799-804. [QxMD MEDLINE Link].

28. Empiric treatment for peritonsillar abscess: A single-center experience with medical therapy alone. Am J Otolaryngol. 2021. 42:102954. [QxMD MEDLINE Link].

29. Johnson RF, Stewart MG, Wright CC. An evidence-based review of the treatment of peritonsillar abscess. Otolaryngol Head Neck Surg. 2003 Mar. 128(3):332-43. [QxMD MEDLINE Link].

30. Spires JR, Owens JJ, Woodson GE, Miller RH. Treatment of peritonsillar abscess. A prospective study of aspiration vs incision and drainage. Arch Otolaryngol Head Neck Surg. 1987 Sep. 113(9):984-6. [QxMD MEDLINE Link].

31. [Guideline] Herzon FS. Harris P. Mosher Award thesis. Peritonsillar abscess: incidence, current management practices, and a proposal for treatment guidelines. Laryngoscope. 1995 Aug. 105(8 Pt 3 Suppl 74):1-17. [QxMD MEDLINE Link].

32. Ron B Mitchell , Sanford M Archer , Stacey L Ishman, et al. Clinical Practice Guideline: Tonsillectomy in Children (Update). Otolaryngol Head Neck Surg . 2019. 160(:S1-S42. [QxMD MEDLINE Link]. [Full Text].

33. Rivera AM, Boucher HW. Current concepts in antimicrobial therapy against select gram-positive organisms: methicillin-resistant Staphylococcus aureus, penicillin-resistant pneumococci, and vancomycin-resistant enterococci. Mayo Clin Proc. 2011 Dec. 86(12):1230-43. [QxMD MEDLINE Link].

34. Powell EL, Powell J, Samuel JR, Wilson JA. A review of the pathogenesis of adult peritonsillar abscess: time for a re-evaluation. J Antimicrob Chemother. 2013 Sep. 68(9):1941-50. [QxMD MEDLINE Link].

35. Klug TE, Rusan M, Clemmensen KK, Fuursted K, Ovesen T. Smoking promotes peritonsillar abscess. Eur Arch Otorhinolaryngol. 2013 Nov. 270(12):3163-7. [QxMD MEDLINE Link].

36. S Ahmed Ali , Kevin J Kovatch , Josh Smith, et al. Predictors of intratonsillar abscess versus peritonsillar abscess in the pediatric patient. Int J Pediatr Otorhinolaryngol. 2018. 114:143-146. [QxMD MEDLINE Link].

Itzhak Brook, MD, MSc Professor, Department of Pediatrics, Georgetown University School of Medicine

Itzhak Brook, MD, MSc is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society for Microbiology, The Society of Federal Health Professionals (AMSUS), Infectious Diseases Society of America, International Immunocompromised Host Society, International Society for Infectious Diseases, Medical Society of the District of Columbia, New York Academy of Sciences, Pediatric Infectious Diseases Society, Society for Experimental Biology and Medicine, Society for Pediatric Research, Southern Medical Association, Society for Ear, Nose and Throat Advances in Children, American Federation for Clinical Research, Surgical Infection Society, Armed Forces Infectious Diseases Society

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Joseph Domachowske, MD Professor of Pediatrics, Microbiology and Immunology, Department of Pediatrics, Division of Infectious Diseases, State University of New York Upstate Medical University

Joseph Domachowske, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa

Disclosure: Received research grant from: Pfizer;GlaxoSmithKline;AstraZeneca;Merck;American Academy of Pediatrics, Novavax, Regeneron, Diassess, Actelion<br/>Received income in an amount equal to or greater than $250 from: Sanofi Pasteur.

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Ashir Kumar, MD, MBBS FAAP, Professor Emeritus, Department of Pediatrics and Human Development, Michigan State University College of Human Medicine

Ashir Kumar, MD, MBBS is a member of the following medical societies: Infectious Diseases Society of America, American Association of Physicians of Indian Origin

Disclosure: Nothing to disclose.

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Gershon Segal, MD, to the development and writing of this article.

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