Implication of Fusobacterium necrophorum in recurrence of peritonsillar abscess
S. Ahmed Ali MD  Kevin J. Kovatch MD  Josh Smith BS  Emily L. Bellile MS  John E. Hanks MD  Paul T. Hoff MD
First published: 24 December 2018 https://doi.org/10.1002/lary.27675
Presented at the Triological Society–Combined Sections Meeting, Coronado, California, U.S.A. January 24–26, 2019.
k.j.k. is supported by the National Institutes of Health (NIH) grant T32 DC005356. The authors have no other funding, financial relationships, or conflicts of interest to disclose.
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Abstract
Objective
Peritonsillar abscess (PTA) is a common infectious complication of pharyngeal infection managed by otolaryngologists and emergency room physicians. Streptococcus and Fusobacterium (e.g., Fusobacterium necrophorum, FN) species are commonly isolated pathogens. The aim of this study was to determine the implication of culture results on abscess recurrence following drainage.

Methods
Single‐institution retrospective review of patients treated at the University of Michigan between 2000 and 2017. Demographic and clinical outcome data were analyzed, including treatment details, culture data, and recurrence.

Results
One hundred fifty‐six of the 990 patients in our study developed recurrence of their abscess (16%). The age ranges most susceptible to recurrence included adolescent (22.9%) and young adult groups (17.1%). Recurrent patients were more likely to have experienced acute progression of symptoms (79% vs. 71%, P = 0.03), trismus (67% vs. 55%, P = 0.006), voice changes (65% vs. 57%, P = 0.04), and dysphagia (72% vs. 61%, P = 0.01) compared to nonrecurrent patients. They were also more likely to have clinical lymphadenopathy noted on initial examination (67% vs. 56%, P = 0.009). Culture data was sent for 852 patients (86%). The presence of FN was significantly more prevalent in the recurrent group (P < 0.0001).

Conclusion
There is a high observed prevalence of FN species within PTA aspirates in the recurrent PTA population. PTA aspirate should be sent for anaerobic growth to screen for Fusobacterium species. In addition, follow‐up and lower threshold for subsequent tonsillectomy should be considered in this at‐risk group.

Level of Evidence
3

Laryngoscope, 129:1567–1571, 2019