Peritonsillar abscess, retropharyngeal abscess, mediastinitis, and nonclostridial anaerobic myonecrosis: a case report

Clin Infect Dis. 1993 Jun:16 Suppl 4:S299-303. doi: 10.1093/clinids/16.supplement_4.s299.

Abstract

Peritonsillar abscess is a potentially life-threatening complication of acute tonsillitis. On occasion, peritonsillar abscess can extend to neck spaces and/or to the mediastinum. We describe a case of a patient with a peritonsillar abscess that extended to the neck, producing bilateral retropharyngeal abscesses and myonecrosis of the strap muscles. Culture of a specimen of the necrotic muscle yielded Prevotella intermedia, Prevotella buccae, Lactobacillus catenaforme, another Lactobacillus species, Peptostreptococcus anaerobius, and some nonanaerobes. Culture of the peritonsillar abscess yielded P. intermedia and P. buccae plus P. anaerobius, Peptostreptococcus asaccharolyticus, Bifidobacterium dentium, viridans and group F streptococci, and Citrobacter diversus. Culture of the retropharyngeal abscess yielded Fusobacterium nucleatum and Actinomyces odontolyticus in addition to most of the aforementioned organisms. The patient underwent repeated drainage and debridement procedures and was treated with various antimicrobial agents and ultimately recovered. This case highlights the polymicrobial nature of peritonsillar abscess and the serious complications that this infection may lead to.

Publication types

  • Case Reports

MeSH terms

  • Abscess / complications*
  • Bacteria, Anaerobic / drug effects
  • Bacteria, Anaerobic / isolation & purification
  • Drug Resistance, Microbial
  • Empyema, Pleural / complications
  • Humans
  • Male
  • Mediastinitis / complications*
  • Middle Aged
  • Muscular Diseases / complications
  • Necrosis
  • Peritonsillar Abscess / complications*
  • Peritonsillar Abscess / drug therapy
  • Peritonsillar Abscess / microbiology
  • Pharyngeal Diseases / complications*