postanginal sepsis

postanginal sepsis

A rare condition most common in adolescents and young adults, caused by a peripharyngeal abscess 2º to tonsillitis, pharyngitis, or dental procedures; the infection spreads by direct extension, or into the lymphatic or venous channels, causing thrombophlebitis of the internal jugular vein, septic emboli and metastatic abscesses, often to lung Clinical Local, abscess-related Sx–oral and facial edema, hoarseness, dysphagia; lung involvement manifest by high fever, rigors, cough, pleuritic chest pain, hemoptysis, dyspnea Microbiology Fusobacterium necrophorum, peptostreptococci, bacteroides, Eikenella corrodens, S aureus etc Lab PMNs
≥ 30,000/mm3, ↑ LFTs, ↓ platelets, ↑ urinary sediment Management 
High-dose IV antibiotics, covering for anaerobes