The vast majority of patients with peritonsillar abscess (PTA) recover uneventfully on abscess drainage and antibiotic therapy. However, occasionally patient´s condition deteriorates as the infection spread in the upper airway mucosa, through cervical tissues, or hematogenously. The bacterial etiology of PTA is unclarified and the preferred antimicrobial regimen remains controversial. The current narrative review was carried out with an aim to (1) describe the spectrum of complications previously recognized in patients with peritonsillar abscess (PTA), (2) describe the bacterial findings in PTA-associated complications, and (3) describe the time relation between PTA and complications. Systematic searches in the Medline and EMBASE databases were conducted and data on cases with PTA and one or more complications were elicited. Seventeen different complications of PTA were reported. The most frequently described complications were descending mediastinitis (n = 113), para- and retropharyngeal abscess (n = 96), necrotizing fasciitis (n = 38), and Lemierre´s syndrome (n = 35). Males constituted 70% of cases and 49% of patients were > 40 years of age. The overall mortality rate was 10%. The most prevalent bacteria were viridans group streptococci (n = 41, 25%), beta-hemolytic streptococci (n = 32, 20%), F. necrophorum (n = 21, 13%), S. aureus (n = 18, 11%), Prevotella species (n = 17, 10%), and Bacteroides species (n = 14, 9%). Simultaneous diagnosis of PTA and complication was more common (59%) than development of complication after PTA treatment (36%) or recognition of complication prior to PTA (6%). Clinicians involved in the management of PTA patients should be aware of the wide range of complications, which may arise in association with PTA development. Especially males and patients > 40 years of age seem to be at an increased risk of complicated disease. In addition to Group A streptococci and F. necrophorum, the current findings suggest that viridans group streptococci, S. aureus, Prevotella, and Bacteroides may also play occasional roles in the development of PTA as well as spread of infection. Complications occasionally develop in PTA patients, who are treated with antibiotics and surgical drainage.

中文翻译：

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扁桃体周围脓肿的并发症。

绝大多数扁桃体周围脓肿（PTA）患者在脓肿引流和抗生素治疗后均能顺利康复。但是，有时病情会随着感染在上呼吸道粘膜中扩散，通过宫颈组织或血源性传播而恶化。PTA的细菌病因尚未阐明，优选的抗菌方案仍存在争议。当前的叙述性综述旨在（1）描述先前在扁桃体周围脓肿（PTA）患者中认识到的并发症的频谱，（2）描述PTA相关并发症中的细菌发现，以及（3）描述时间PTA与并发症之间的关系。在Medline和EMBASE数据库中进行系统搜索，并获得PTA病例和一种或多种并发症的数据。报道了17种不同的PTA并发症。描述最频繁的并发症是下降性纵隔炎（n = 113），咽旁和咽后脓肿（n = 96），坏死性筋膜炎（n = 38）和Lemierre综合征（n = 35）。男性占病例的70％，年龄大于40岁的患者占49％。总死亡率为10％。最普遍的细菌是vi虫类链球菌（n = 41，25％），β-溶血性链球菌（n = 32，20％），坏死镰刀菌（n = 21，13％），金黄色葡萄球菌（n = 18， 11％），小球藻（n = 17、10％）和拟杆菌（n = 14、9％）。PTA和并发症的同时诊断（59％）比PTA治疗后并发症的发展（36％）或PTA之前对并发症的认识（6％）更为普遍。参与PTA患者管理的临床医生应意识到与PTA发展相关的各种并发症。尤其是男性和年龄大于40岁的患者患复杂疾病的风险似乎更高。除了A组链球菌和坏死镰刀菌外，目前的发现还表明，绿箭虫类链球菌，金黄色葡萄球菌，普雷沃特氏菌和拟杆菌也可能在PTA的发展以及感染传播中偶尔发挥作用。接受抗生素和外科引流治疗的PTA患者有时会出现并发症。死灵菌，目前的发现表明，绿藻类群链球菌，金黄色葡萄球菌，普雷沃特氏菌和拟杆菌也可能在PTA的发展以及感染传播中偶尔发挥作用。接受抗生素和外科引流治疗的PTA患者有时会出现并发症。死灵菌，目前的发现表明，绿藻类群链球菌，金黄色葡萄球菌，普雷沃特氏菌和拟杆菌也可能在PTA的发展以及感染传播中偶尔发挥作用。接受抗生素和外科引流治疗的PTA患者有时会出现并发症。