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Variation in patient presentation and the use of computer tomography in the urgent care diagnosis and treatment of peritonsillar abscess
  • Christopher Bell,
  • Justin Chau
Christopher Bell
Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cumming's School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Justin Chau
Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cumming's School of Medicine, University of Calgary, Calgary, Alberta, Canada

Corresponding Author:[email protected]

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Abstract

Background
A peritonsillar abscess (PTA) is a collection of infectious material within the peritonsillar space, seen most often in teenagers and young adults. The diagnosis of a PTA is reliant on a patient’s history and physical exam; however, CT scans continue to be used. The rationale for imaging in the diagnosis of a PTA may be better understood based on patient presenting symptoms and physical exam findings.
Methods
A retrospective review of adult patients diagnosed with a peritonsillar abscess in an acute care/emergency setting at a tertiary hospital between January 1 to December 31, 2019, was performed. Patients were arranged into two groups: those who underwent a CT scan versus patients who did not scan as part of their clinical work-up. Patient demographics, and differences in the rate of subjective and objective findings were compared.
Results
43 patients were included in the study: 19 in the CT scan group, and 23 in the no-CT scan group. There was no statistically significant difference in the history of previous peritonsillar abscess incidence, patient chief complaint at triage, subjective complaints, or objective physical exam findings. The most common patient reported symptoms in both groups were odynophagia and dysphagia. The most common objective findings in both groups included peritonsillar fullness and erythema, and uvular deviation.
Conclusion
Patients who underwent a CT scan as part of their work-up for a peritonsillar abscess had no difference in symptoms or physical exam findings when compared to patients who did not have a CT scan.