What causes peritonsillar abscesses (PTAs)?

Updated: Sep 03, 2020
  • Author: Jorge Flores, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

Peritonsillar abscesses are usually polymicrobial. A recent prospective study carried out to elucidate significant pathogens involved in peritonsillar abscesses demonstrated that the most prominent aerobic pathogen was Streptococcus pyogenes. Other aerobic pathogens isolated included Staphylococcus aureus,Neisseria species, and Corynebacterium species. In the same study, the most common anaerobic species found was Fusobacterium necrophorum, an obligate, anaerobic, Gram-negative rod. Other Fusobacterium species and Prevotella species were also isolated. A literature review demonstrated that the Streptococcus milleri group, a facultative anaerobic group of bacteria, is also commonly associated with peritonsillar infection. Though these studies are European publications, studies within the United States have demonstrated similar results. [5, 13, 4, 14, 15]

The aforementioned literature review by Klug et al reported that the most prevalent bacteria in peritonsillar abscess are viridans group streptococci (25%), beta-hemolytic streptococci (20%), Fusobacterium necrophorum (13%), Staphylococcus aureus (11%), Prevotella species (10%), and Bacteroides species (9%). [11]


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