PERITONSILLAR ABSCESS, RETROPHARYNGEAL ABSCESS, MEDIASTINITIS, AND NONCLOSTRIDIAL ANAEROBIC MYONECROSIS - A CASE-REPORT

Peritonsillar abscess is a potentially life-threatening complication o f acute tonsillitis. On occasion, peritonsillar abscess can extend to neck spaces and/or to the mediastinum. We describe a case of a patient with a peritonsillar abscess that extended to the neck, producing bil ateral retropharyngeal abscesses and myonecrosis of the strap muscles. Culture of a specimen of the necrotic muscle yielded Prevotella inter media, Prevotella buccae, Lactobacillus catenaforme, another Lactobaci llus species, Peptostreptococcus anaerobius, and some nonanaerobes. Cu lture of the peritonsillar abscess yielded P. intermedia and P. buccae plus P. anaerobius, Peptostreptococcus asaccharolyticus, Bifidobacter ium dentium, viridans and group F streptococci, and Citrobacter divers us. Culture of the retropharyngeal abscess yielded Fusobacterium nucle atum and Actinomyces odontolyticus in addition to most of the aforemen tioned organisms. The patient underwent repeated drainage and debridem ent procedures and was treated with various antimicrobial agents and u ltimately recovered. This case highlights the polymicrobial nature of peritonsillar abscess and the serious complications that this infectio n may lead to.