Clinical predictors of peritonsillar abscess in adults.

OBJECTIVE: The primary objective was to identify clinical predictors that differentiate a peritonsillar abscess from peritonsillar cellulitis in adults. The secondary objective was to identify the prevalence of tobacco smoking behaviour in this group of patients with peritonsillitis.

SETTING: The Ottawa Hospital, a tertiary care centre.

METHODS: Retrospective chart review of patients diagnosed with peritonsillar abscess or peritonsillar cellulitis in the adult emergency department of The Ottawa Hospital during the years 2002 to 2004.

RESULTS: The charts of 130 patients with peritonsillitis were reviewed. Patients' ages ranged from 16 to 91 years. Fifty patients were diagnosed with a peritonsillar abscess and 80 with peritonsillar cellulitis. Forty-four percent of the patients in this study admitted to active tobacco smoking behaviour. Clinical signs significantly associated with peritonsillar abscess included trismus (p < .001), uvular deviation (p < .001), and inferior displacement of the superior pole of the tonsil (p < .001) on the affected side. Pain duration was not a significant discriminative factor (p = .069).

CONCLUSIONS: The diagnosis of a peritonsillar abscess is based on clinical findings. In this study, the prevalence of tobacco smoking behaviour in patients with peritonsillar disease was high. Further study is recommended to investigate the potential causal effects of tobacco smoke on the development of peritonsillar disease.