Tonsillitis is a common disease of childhood and adolescence. The diagnosis of tonsillitis generally requires the consideration of Group A beta-hemolytic Streptococcus (GABHS) infection. However, numerous other bacteria alone or in combinations, viruses and other infections and non-infectious causes should be considered. Recognition of the cause and choice of appropriate therapy are of utmost importance in assuring rapid recovery and preventing complications.

Penicillin is currently the first-choice treatment for GABHS pharyngotonsillitis. However, the growing failure of penicillin to eradicate GABHS is of concern. This website discusses the potential causes of penicillin failure ( i.e. the presence of beta-lactamse producing bacteria that can “protect” GABHS from penicillins) and methods to overcome them. It also discusses the role of anaerobic bacteria in tonsillitis and its complications.


Wednesday, June 1, 2022

Retropharyngeal abscess- An unusual complication in a COVID-19 patient

 The coronavirus disease 2019 (COVID-19) pandemic has generated many challenges for physicians, including multiple long-term effects that are still being studied. We report a CASE of patient who developed a retropharyngeal abscess post-COVID19 infection. 

Awobaio et al. from the University of Texas Health Science Center at San Antonio, Texas,  reported a CASE of a female who was diagnosed with COVID19 pneumonia and hospitalized for a week at an outside institute. Approximately 3 weeks post discharge she developed neck pain, dysphagia, voice change and odynophagia for which she went to an outside emergency department. A soft tissue neck CT was performed and was concerning for retropharyngeal abscess. The patient was then transferred to our institution. On arrival, a CT scan of the neck and nasopharyngoscopy were performed and biopsies of the epiglottis and right inferior tonsillar pole were taken. Biopsies of the epiglottis and tonsil showed acute inflammation, spongiosis, edema and marked dilation of the lymphatics. Her clinical course was complicated by persistent infection requiring multiple washouts, hyperglycemia, tube feed intolerance, dysphagia and deconditioning. A multi-disciplinary approach was instituted for appropriate management. 

This case report highlights the necessity for close follow up after recovery from COVID-19 infection, particularly in patients with multiple comorbidities.



Retropharyngeal abscess