Paratonsilar Abscess / Tonsilitis
Paratonsilar Abscess / Tonsilitis
Patient with clinical peritonsillar abscess or tonsilitis
If drainage is indicated - done in main ED
Other deep space infections of the neck ruled out (clinically or by imaging)
Stridor at rest (should go to ICU)
Concern for decompensating or rapidly evolving airway
Unstable vital signs
Antibiotics
Suggested regimen
Unsyn 3g Q8hours
Clindamycin 600 mg Q6h
Steroids
Dexamethasone 10 mg Q12 hr if no contraindication
Pain Control
Acetaminophen, Ketoralac 1st line
Opiates as needed
Continuous Pulse Oximetry
IV fluids as needed if not taking PO
ENT consult as needed
Disposition
Able to tolerate PO, secretions
Pain Controlled
Recommend f/u with PCP and or ENT
Worsening Pain
Unstable vital signs
Need for ENT surgical intervention