Although these processes are now uncommon, prompt recognition is mandatory because antibiotics and surgical drainage are required to control infection and to prevent obstruction of the airway, invasion of vital neurologic and vascular structures, and spread of infection to the mediastinum and bloodstream. Group A streptococci are the primary cause of the condition, though most peritonsillar abscesses also harbor mixed oral bacteria, with a predominance of anaerobes. Patients have fever and sore throat, often with pain referred to the ear. Trismus occurs in some patients. CT scans are helpful in diagnosis and management.
Treatment consists of parenteral penicillin and surgery.
Patients have fever and systemic toxicity as well as neck pain, dysphagia, muffled voice, and respiratory stridor. Physical findings include erythema and bulging of the posterior wall of the pharynx. Although the bacterial agent of retropharyngeal infections is not determined in many patients, streptococci and other mouth flora predominate. Penicillin is the traditional antibiotic of choice, but agents that provide a broader spectrum of antibacterial coverage may be justified until culture data are available. Surgical drainage is vital to prevent asphyxiation and extension of infection to the mediastinum.