Predictive factors of abscessing tonsillitis: a retrospective analysis

Background  The diagnosis of a peritonsillar abscess is usually based on clinical symptoms. Nowadays, supplementary examination procedures such as laboratory parameters and imaging are available to us in order to differentiate a complicated, abscessing course from simple tonsillitis in the case of unclear clinical findings and to adjust the therapy at an early stage.

Materials and methods  A retrospective analysis of data from 752 patients who presented with acute tonsillar infection and were hospitalized between January 2012 and February 2021 was performed. This involved an evaluation of the patients’ clinical symptoms, inflammatory parameters, and past medical history in terms of their predictive power for the presence of an abscess.

Results Predictor analysis for the presence of an abscess showed significant values for trismus (p=.000, OR 2.392 (1.305-4.383 95%CI)) and palatal arch protrusion (p=.000; OR 29.679 (17.460-50.447 95%CI)). The inflammatory parameters CRP and leukocyte count did not prove to be statistically significant predictors.

Conclusion  The presence of a tonsillar abscess can be diagnosed by clinical presentation alone if the findings are obvious. Further diagnostics are indicated in case of inconclusive findings, where sonography should be the primary noninvasive method. Only in selected cases CT scanning is required. Inflammatory parameters can be determined to monitor therapy but do not predict the presence of an abscess. If defined action sequences are considered, tonsillar abscesses can be differentiated at an early stage. Further diagnostic tools such as imaging can be used in a targeted and resource-saving manner.

Publication History

Article published online:
12 May 2023