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Peritonsillitis and paratonsillar abscess

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Peritonsillitis and paratonsillar abscess
Diagnosis and treatment of a peritonsillitis and paratonsillar abscess

Peritonsillitis - an inflammation of the fabrics surrounding a palatine tonsil.
Paratonsillar (okolomindalikovy) abscess - the abscess forming in okolomindalikovy cellulose as a result of the previous purulent inflammation.

Epidemiology

Peritonsillitis and paratonsillar abscess - processes, as a rule, unilateral. Diseases meet at young people more often, is more rare - at children's and advanced age.

Classification

Depending on localization of process and features of a clinical course of a disease, allocate a supratonsillar and retrotonsillar peritonsillitis and paratonsillar abscess. In the first case the center is located over an upper pole of palatine tonsils or between an almond and a front palatal handle, in the second - behind palatine tonsils. Retrotonsillar paratonsillar abscess is much more difficult for diagnosis and opening.

Etiology and pathogeny

The main activators of a peritonsillitis and paratonsillar abscess are Streptococcus pyogenes of group A and Staphylococcus aureus; also anaerobic microorganisms are of great importance. Besides, paratonsillar abscess can have a polymicrobial etiology.
The peritonsillitis and paratonsillar abscess develop in case of penetration of the activator from crypts of the struck palatine tonsil through its capsule in a surrounding peritonsillar fat and intermuscular spaces. Infiltrate which for lack of adequate therapy passes into a stage of purulent fusion is as a result formed and paratonsillar abscess forms.

Clinical signs and symptoms

The peritonsillitis usually arises on 2 - the 3rd day of quinsy and is characterized by the sharp deterioration in the general condition of the patient expressed by fervescence and severe pain in a throat on the party of defeat. Pain can irradiate in a neck and parotid area, amplify at reception of liquid and food, a sglatyvaniya of saliva and turn of the head. The voice at the same time becomes nasal; poperkhivaniye, hit of food in a nasopharynx, and also difficulty are possible when opening a mouth owing to a lockjaw of chewing muscles. The lockjaw can have various degree of manifestation - from easy pain when opening a mouth and the chewing movements to an utter impossibility to open a mouth.
Remittiruyushchy fever and pastosity of fabrics at an angle of a mandible are characteristic of retrotonsillar paratonsillar abscess. The disease is followed by the expressed reaction of regional cervical lymph nodes and the phenomena of intoxication.
If surgical treatment, perhaps spontaneous opening of paratonsillar abscess is not carried out to a gleam of a throat or further distribution of purulent process on parapharyngeal cellulose and interfascial kletchatochny spaces of a neck up to a front mediastinum.

Complications

At inadequate treatment development of such complications as is possible:
· neck phlegmon;
· mediastinitis;
· tonzillogenny sepsis;
· the ascending thrombosis of large venous vessels.



 
"Acute laryngotracheitis and acute stenosis of a throat   The pleural exudate caused by medicines"