Variation in patient presentation and the use of computer tomography in
the urgent care diagnosis and treatment of peritonsillar abscess
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.