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European Archives of Oto-Rhino-Laryngology

, Volume 270, Issue 12, pp 3163–3167 | Cite as

Smoking promotes peritonsillar abscess

  • Tejs Ehlers KlugEmail author
  • Maria Rusan
  • Kim Katrine Bjerring Clemmensen
  • Kurt Fuursted
  • Therese Ovesen
Head and Neck

Abstract

Peritonsillar abscess (PTA) is a frequent complication to acute tonsillitis, in particular in adolescents and young adults. Smoking is most commonly initiated during adolescence and young adulthood. The study examines whether smoking increases the risk of PTA and whether smoking is associated with the bacterial findings in PTA. All patients with PTA admitted to the Ear–Nose–Throat Department at Aarhus University Hospital from January 2001 through December 2006 were included in the study. Age- and gender-stratified data on smoking habits in the Danish population and demographic data for Aarhus County for the same 6 years were obtained. Smoking status was available for 679 (80 %) of 847 patients with PTA. 247 (36 %) patients admitted to daily tobacco smoking. Age-stratified odds ratios of smokers compared to non-smokers, for developing PTA, were in the range of 1.9–4.7. Fusobacterium necrophorum and beta-hemolytic streptococci were equally distributed between smokers and non-smokers. Twenty nine percent of the higher incidence of PTA among males compared to females could be explained by a higher prevalence of smoking in males. After correcting for differences in smoking prevalence by gender, the risk of PTA was calculated to be 9.5  % higher among males than females. Smoking was associated with significantly increased risk of PTA in both males and females of all ages. No differences in the microbiological flora of smokers and non-smokers with PTA were found.

Keywords

Peritonsillar abscess Microbiology Fusobacterium necrophorum Smoking Tobacco Pathogenesis 

Notes

Conflict of interest

None.

References

  1. 1.
    Ehlers Klug T, Rusan M, Fuursted K, Ovesen T (2009) Fusobacterium necrophorum: most prevalent pathogen in peritonsillar abscess in Denmark. Clin Infect Dis 49:1467–1472PubMedCrossRefGoogle Scholar
  2. 2.
    Muir DC, Papesch ME, Allison RS (1995) Peritonsillar infection in Christchurch 1990–2: microbiology and management. NZ Med J 108:53–54Google Scholar
  3. 3.
    Hanna BC, McMullan R, Gallagher G, Hedderwick S (2006) The epidemiology of peritonsillar abscess disease in Northern Ireland. J Infect 52:247–253PubMedCrossRefGoogle Scholar
  4. 4.
    Risberg S, Engfeldt P, Hugosson S (2008) Incidence of peritonsillar abscess and relationship to age and gender: retrospective study. Scand J Infect Dis 18:1–5Google Scholar
  5. 5.
    McIsaac WJ, White D, Tannenbaum D, Low DE (1998) A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ 158:75–83PubMedGoogle Scholar
  6. 6.
    Vestergaard H, Wohlfahrt J, Westergaard T, Pipper C, Rasmussen N, Melbye M (2007) Incidence of tonsillectomy in Denmark, 1980 to 2001. Pediatr Infect Dis J 26:1117–1121PubMedCrossRefGoogle Scholar
  7. 7.
    Klug TE, Henriksen JJ, Fuursted K, Ovesen T (2011) Significant pathogens in peritonsillar abscesses. Eur J Clin Microbiol Infect Dis 30:619–627PubMedCrossRefGoogle Scholar
  8. 8.
    Jensen A, Hagelskjaer Kristensen L, Prag J (2007) Detection of Fusobacterium necrophorum subsp. funduliforme in tonsillitis in young adults by real-time PCR. Clin Microbiol Infect 13:695–701PubMedCrossRefGoogle Scholar
  9. 9.
    Batty A, Wren MW (2005) Prevalence of Fusobacterium necrophorum and other upper respiratory tract pathogens isolated from throat swabs. Br J Biomed Sci 62:66–70PubMedGoogle Scholar
  10. 10.
    Aliyu SH, Marriott RK, Curran MD et al (2004) Real-time PCR investigation into the importance of Fusobacterium necrophorum as a cause of acute pharyngitis in general practice. J Med Microbiol 53:1029–1035PubMedCrossRefGoogle Scholar
  11. 11.
    Amess JA, O’Neill W, Giollariabhaigh CN, Dytrych JK (2007) A six-month audit of the isolation of Fusobacterium necrophorum from patients with sore throat in a district general hospital. Br J Biomed Sci 64:63–65PubMedGoogle Scholar
  12. 12.
    Murray PR, Baron EJ, Jorgensen JH et al (2007) Manual of clinical microbiology, 9th edn. ASM Press, Washington, DCGoogle Scholar
  13. 13.
    Statistics Denmark. http://www.statbank.dk table BEF1A, March 2012
  14. 14.
    Dilkes MG, Dilkes JE, Ghufoor K (1992) Smoking and quinsy. Lancet 339:1552PubMedCrossRefGoogle Scholar
  15. 15.
    Lehnerdt G, Senska K, Fischer M, Jahnke K (2005) Smoking promotes the formation of peritonsillar abscesses. Laryngorhinootologie 84:676–679PubMedCrossRefGoogle Scholar
  16. 16.
    Kilty SJ, Gaboury I (2008) Clinical predictors of peritonsillar abscess in adults. J Otolaryngol Head Neck Surg 37:165–168PubMedGoogle Scholar
  17. 17.
    Marom T, Cinamon U, Itskoviz D, Roth Y (2010) Changing trends of peritonsillar abscess. Am J Otolaryngol 31:162–167PubMedCrossRefGoogle Scholar
  18. 18.
    Hidaka H, Kuriyama S, Yano H, Tsuji I, Kobayashi T (2011) Precipitating factors in the pathogenesis of peritonsillar abscess and bacteriological significance of the Streptococcus milleri group. Eur J Clin Microbiol Infect Dis 30:527–532PubMedCrossRefGoogle Scholar
  19. 19.
    Palmer RM, Wilson RF, Hasan AS, Scott DA (2005) Mechanisms of action of environmental factors–tobacco smoking. J Clin Periodontol 32(Suppl 6):180–195PubMedCrossRefGoogle Scholar
  20. 20.
    Brook I, Gober AE (2007) Effect of smoking cessation on the microbial flora. Arch Otolaryngol Head Neck Surg 133:135–138PubMedCrossRefGoogle Scholar
  21. 21.
    Brook I, Gober AE (2005) Recovery of potential pathogens and interfering bacteria in the nasopharynx of smokers and nonsmokers. Chest 127:2072–2075PubMedCrossRefGoogle Scholar
  22. 22.
    El Ahmer OR, Essery SD, Saadi AT, Raza MW, Ogilvie MM, Weir DM, Blackwell CC (1999) The effect of cigarette smoke on adherence of respiratory pathogens to buccal epithelial cells. FEMS Immunol Med Microbiol 23:27–36PubMedCrossRefGoogle Scholar
  23. 23.
    Fainstein V, Musher DM (1979) Bacterial adherence to pharyngeal cells in smokers, nonsmokers, and chronic bronchitics. Infect Immun 26:178–182PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Tejs Ehlers Klug
    • 1
    Email author
  • Maria Rusan
    • 1
    • 2
    • 4
  • Kim Katrine Bjerring Clemmensen
    • 3
  • Kurt Fuursted
    • 2
  • Therese Ovesen
    • 1
  1. 1.Department of Otorhinolaryngology, Head and Neck SurgeryAarhus University HospitalAarhus CDenmark
  2. 2.Department of Clinical MicrobiologyAarhus University HospitalAarhusDenmark
  3. 3.Department of Prevention and DocumentationDanish Cancer SocietyCopenhagenDenmark
  4. 4.Institute of Clinical MedicineAarhusDenmark

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