Management of Intratonsillar Abscess in Children

Abstract

Objective: Assess outcomes of medical and surgical treatment of intratonsillar abscess in children.

Method: The medical charts of infants and children who were treated for intratonsillar abscess between December 2009 and September 2010 were reviewed to obtain information on history and physical examination, imaging, management, and follow-up assessment.

Results: Seven children (age range: 4 to 18 years) presented with difficulty swallowing and decreased oral intake. Trismus was present in 3 patients, and respiratory distress was present in 1. CT imaging documented unilateral abscess in 7 patients and phlegmon in the contralateral tonsil in 2. Inflammatory changes were observed in parapharyngeal space in 6 patients, prevertebral space in 1, and pyriform sinus and aryepiglottic folds in 3. One patient with respiratory distress underwent drainage of abscess prior to antibiotic treatment. In the remaining six children, medical treatment included clindamycin and corticosteroid in 4 patients and clindamycin, corticosteroid, and ceftriaxone in 2 patients.

Conclusion: In children with no airway compromise, intratonsillar abscess responded to trial of antibiotic therapy and corticosteroid. Surgical drainage accomplished clinical resolution of intratonsillar abscess in the presence of airway compromise or unresponsiveness to trial of medical treatment.