Tonsillitis, Tonsillar Hypertrophy, and Peritonsillar/Retropharyngeal Abscess

Question 1

GAS Antibiotic options

Answer 1

Penicillin or Amoxicillin
First-gen Cephalosporin (PCN allergy without anaphylaxis)
Clindamycin or Macrolide (PCN allergy with anaphylaxis)

single IM penicillin G benzathine if not tolerate 10-day course

Question 2

What are the most common organisms associated with Peritonsillar Abscesses?

Answer 2

polymicrobial; Streptococcus and Fusobacterium

Question 3

What is Lemierre Syndrome?

Answer 3

septic thrombophlebitis of the internal jugular vein

Question 4

Diagnosing Peritonsillar Abscess

Answer 4

intraoral ultrasonography or CT (should be avoided if possible due to radiation-sensitive structures in the neck)

Question 5

Treatment of Peritonsillar Abscess

Answer 5

drainage by ENT + culture and Abx

Abx: PCN, cephalosporin, clindamycin for 7 days

Question 6

Treatment of Retropharyngeal Abscess

Answer 6

24-48 hrs of broad spectrum parenteral Abx

• no response? –> surgical drainage

Question 7

Two main indications for Tonsillectomy

Answer 7

Sleep-disordered breathing (SDB)

Severe recurrent throat infections

Question 8

Recurrent tonsillar infection is defined as what?

Answer 8

7+ throat infections in 1 year
5+ infections per year for 2 years
3+ infections per year for 3 years