RESUMO
The microbiological cause of peritonsillar abscess and the role of group A ß-haemolytic Streptococcus (GAS) are unclear. We performed a retrospective study at the ear, nose and throat clinic (ENT) of Orebro University Hospital, Sweden, and included 376 events of peritonsillitis between 2002 and 2004. We determined if the patients had visited a primary healthcare centre (PHCC) within 30 days prior to inclusion. The results of the rapid antigen detection test for GAS (Strep A) taken at the PHCC were compared with the occurrence of peritonsillar abscess (PTA) and peritonsillar cellulitis (PTC). A Strep A test was performed in 61% (229/376) of the events studied. Strep A was positive in 22% of PTA events and in 35% of PTC events (p = 0.036). Of 48,000 Strep A tests taken in primary healthcare, mainly for sore throat, 22% were positive. We examined the relationship between age, the incidence of PTA, and positive Strep A tests. We also determined if there was a monthly correlation between number of positive Strep A tests and number of PTA events. We found no significant correlations. In conclusion, our findings indicate that GAS does not play a major role in the development of PTA/PTC.
Assuntos
Antígenos de Bactérias/análise , Celulite (Flegmão)/epidemiologia , Abscesso Peritonsilar/epidemiologia , Infecções Estreptocócicas/epidemiologia , Streptococcus pyogenes/isolamento & purificação , Adolescente , Antígenos de Bactérias/imunologia , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/microbiologia , Criança , Feminino , Humanos , Incidência , Masculino , Abscesso Peritonsilar/diagnóstico , Abscesso Peritonsilar/microbiologia , Kit de Reagentes para Diagnóstico/estatística & dados numéricos , Estudos Retrospectivos , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Streptococcus pyogenes/imunologia , Fatores de Tempo , Adulto JovemRESUMO
The incidence of peritonsillitis is not very well known. A retrospective study was performed at the Ear, Nose and Throat clinic (ENT) at the University Hospital of Orebro Sweden. We studied every case from 2002 to 2004 and related it to a well-defined catchment area of 179,200 inhabitants. We identified 283 events of peritonsillitis, of which 85 were defined as peritonsillar cellulitis (PTC). Peritonsillar abscess (PTA) was found in 198 events in patients between 7 and 82 y of age. 13 patients had 2 episodes of PTA during the study period. The overall incidence was 37/100,000/y. The highest incidence was found between 14 and 21 y of age, with 124/100,000/y. The male: female ratio was 1: 1. Affected females were younger than males (p=0.04), and the peak incidence was earlier for females. This may be due to differences in immunological response, owing to hormonal maturation. The annual incidence of PTA was higher in this study than found in previous studies, which is probably attributable to the fact that our study identified almost all cases in the population.
