Acute tonsillitis vs. tonsillar abscess: Do laboratory inflammation parameters help in the diagnostic process? – a retrospective analysis of 134 cases of an ENT clinic

Introduction:

The clinically distinction between an acute tonsillitis and a tonsillar abscess is often not easily possible because you do not find the typical clinical presentation in every patient. This retrospective analysis of the current inflammatory parameters in the blood (CRP, leukocytes) should clarify whether these can possibly be used as a decision aid in making a diagnosis.

Methods:

All cases of inpatient treatment of acute tonsillitis as well as an intra- or peritonsillar abscess were examined in the period from 01.01.2017 to 09.10.2017 in the ENT Department of the University Hospital Frankfurt. There were data on a total of 134 cases, among them 50 patients with acute tonsillitis versus 84 cases with a peri- or intratonsillar abscess. CRP values were compared with those of the cohort of abscesses in the patient population with acute tonsillitis on the day of hospital admission. We also compared the leukocyte values of both groups. For the statistical comparisons, the double-sided T-test was used at a significance level p < 0.05.

Results:

It was found that neither the CRP value (p = 0.4173) nor the leukocyte value (p = 0.1453) in the T-test was significantly different between the group with acute tonsillitis and the intra- or peritonsillar abscess.

Conclusion:

Although the inflammation values are generally increased, the diagnosis cannot be predicated on the laboratory inflammation parameters. Furthermore, the clinical presentation of the patient and the ENT-findings should be the focus of the diagnostic process. In the case of unclear clinical findings or punctio sicca a CT of the soft tissues of the neck should always be performed.

Publication History

Publication Date:
18 April 2018 (online)