Utility of CT in the workup of adults with sore throat in the emergency department

Gilley, David R.; Virdi, Gurpal S.; Namin, Arya W.; Dooley, Laura

doi:10.1016/j.ajem.2021.09.063

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…Tonsillitis accounts for a large percentage of patients visiting the emergency department (ED) for a sore throat [ 1 ]. Acute infection of the tonsil may involve the skin and mucous membranes and spread to surrounding connective tissues, forming an abscess, which could develop into deep neck infection (DNI) [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Predictive Performance Neutrophil-to-Lymphocyte Ratio of Acute Tonsillitis with Deep Neck Space Infection in Adult Patients

Lee,

Oh,

Choi

et al. 2023

Emergency Medicine International

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The aim of this study was to examine the neutrophil-to-lymphocyte ratio (NLR) in patients diagnosed with a deep neck infection (DNI) to identify helpful indicators for the initial differential diagnosis. This study was conducted as a single-center, retrospective cohort study that utilized data from the electronic medical records of patients who visited the emergency department in a tertiary university hospital between February 2018 and April 2022. The study enrolled patients aged ≥18 years who were diagnosed with tonsillitis with or without DNI during the study period. The NLR of patients without DNI was 6.1 ± 5.03, and the NLR of patients with acute tonsillitis with DNI was 8.0 ± 5.67, showing significant differences. The rate of admission in the general wards (GWs) and ICUs was significantly higher in patients with DNI, and the length of hospital stay was also significantly longer in patients with DNI. Older age, male, lower body temperature, C-reactive protein, and NLR were significant independent risk factors for DNI in patients with tonsillitis. The cutoff value for predicting DNI in patients with body temperature <37.5 was 3.09. The NLR of patients with tonsillitis, especially those with normal body temperature, can be used to predict their prognosis.

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Section: Introductionmentioning

confidence: 99%

Predictive Performance Neutrophil-to-Lymphocyte Ratio of Acute Tonsillitis with Deep Neck Space Infection in Adult Patients

Lee,

Oh,

Choi

et al. 2023

Emergency Medicine International

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Peritonsillar Abscess Outcomes with and Without Computed Tomography: A Retrospective Cohort Study

Kadrie,

Ward,

Chanamolu

et al. 2024

The Laryngoscope

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ObjectivesPeritonsillar abscess (PTA) is a common deep space head and neck infection, which can be diagnosed with or without computed tomography (CT). CT poses a risk for false positives, leading to unnecessary abscess drainage attempts without benefit, whereas needle or open aspiration without imaging could potentially lead to missed abscess in need of treatment. This study considered the utility and impact of obtaining CT scans in patients with suspected PTA by comparing outcomes between CT and non‐CT usage.MethodsRetrospective cohort analysis using TriNetX datasets compared the outcomes of two cohorts: PTA without CT and PTA with CT. Measured outcomes included incision and drainage; quinsy adenotonsillectomy; recurrent PTA; airway emergency/obstruction; repeat emergency department (ED) visits; and need for antibiotics, opiates, or steroids. Odds ratios (OR) were calculated using a cohort analysis.ResultsThe CT usage group had increased odds of receiving antibiotics (OR 3.043, [2.043–4.531]), opiates (OR 1.614, [1.138–1.289]), and steroids (OR 1.373, [1.108–1.702]), as well as a higher likelihood of returning to the ED (OR 5.900, [3.534–9.849]) and developing a recurrent PTA (OR 1.943, [1.410–2.677]). No significant differences were observed in the incidence of incision and drainage, quinsy adenotonsillectomy, or airway emergency/obstruction.ConclusionOur study indicated that CT scans for PTA diagnosis were associated with increased prescription of antibiotics, opioids, steroids, return ED visits, and recurrent PTA. Future prospective trials are needed to determine if the use of CT scans indicates higher patient acuity that explains the potential negative outcomes.Level of EvidenceLevel II Laryngoscope, 2024

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Utility of CT in the workup of adults with sore throat in the emergency department

Cited by 2 publications

References 10 publications

Predictive Performance Neutrophil-to-Lymphocyte Ratio of Acute Tonsillitis with Deep Neck Space Infection in Adult Patients

Predictive Performance Neutrophil-to-Lymphocyte Ratio of Acute Tonsillitis with Deep Neck Space Infection in Adult Patients

Peritonsillar Abscess Outcomes with and Without Computed Tomography: A Retrospective Cohort Study

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