Pus obtained by needle aspiration of 91 peritonsillar abscesses was examined microbiologically. A positive culture was obtained in 55 patients (60 per cent). Sixty-four bacteriological isolates were grown. Forty patients had a pure growth of a single organism, of which 21 (53 per cent) were beta Haemolytic streptococci. Pure growths of Staphylococcus aureus were found in only three patients. Fifteen patients had mixed organisms, including anaerobes, in their pus and the resistance to penicillin was low. Only the bacteroides species were generally penicillin resistant. The vast majority of patients made a good recovery following needle drainage of the abscess and treatment with parenteral penicillin. The patients with a mixture of penicillin sensitive and penicillin resistant organisms also made a good clinical recovery following needle drainage and administration of parenteral penicillin. The relevance of these findings in the pathogenesis and management of peritonsillar sepsis is discussed.

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Rat peritoneal macrophages incubated in a medium with 10% autologous serum showed 50% inhibition of O2 consumption by 0.4 mM zinc only when activated by yeast. Zinc ions had no effect on resting macrophages. The inhibitory efficiency of zinc depended on the ratio of yeast particles to macrophages; with more activated cells, the inhibition was less. The multiple-shaped intact macrophages changed into rounded cells in the presence of 0.1 and 0.5 mM Zn2+ as shown by photomicrography and scanning electron microscopy. When the incubation medium was replaced by zinc-free medium, cells recovered and became irregularly shaped. The reversibility of zinc effect on cell morphology corresponded with uptake and release of zinc by macrophages. The presence of serum in the medium interfered with the magnitude of zinc uptake by macrophages. We conclude that besides already reported effects of zinc on mast cells, platelets, and granulocytes, zinc ions also inhibit some functions of macrophages.

172 consecutive patients admitted with suspected unilateral peritonsillar sepsis were studied. Needle aspiration of the peritonsillar space was performed, and they were all then treated with intravenous antibiotics (usually benzylpenicillin). Any pus obtained was cultured. The aspiration was repeated if the patient was not improving after 24 h. A quantity of pus was aspirated at the first attempt from 91 patients (53%); 82 of these required no further aspiration but 7 required a further single aspiration and 2 required a further 2 aspirations before resolution of the sepsis. 71 of the 81 patients (88%) from whom pus had not been aspirated, and who were therefore initially considered to have peritonsillar cellulitis, required no further aspirations. However, 6 subsequently drained pus spontaneously and 4 produced a positive aspirate on a second occasion. Four patients required a change in their antibiotic therapy. We have found the combination of needle aspiration and parenteral antibiotics to be an effective treatment of peritonsillar sepsis. All patients were spared the unpleasant and painful experience of an incision and drainage procedure.