Skip to main content

Advertisement

Log in

The role of viruses in the pathogenesis of peritonsillar abscess

  • Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Peritonsillar abscess (PTA) is the most frequent complication of acute tonsillitis and a prevalent cause for acute admission to otorhinolaryngology departments. Our aim was to examine the role of viruses in the pathogenesis of PTA, as this has not previously been considered. We examined both palatine tonsils from 25 patients undergoing acute tonsillectomy for PTA, using PCR-based assays for herpes simplex virus-1 and -2 (HSV-1 and -2), adenovirus, Epstein-Barr virus (EBV), influenza A and B, and respiratory syncytial virus (RSV) A and B. We similarly examined tonsils from 55 patients undergoing elective tonsillectomy due to chronic tonsillar conditions. These patients served as a control group, as they did not have a clinically apparent infection at the time of surgery. Only HSV-1 (5/80, 6.3%), adenovirus (11/80, 13.8%), and EBV (71/80, 88.8%) were detected in our study population. There was no statistically significant difference in the frequency of these viruses across different diagnostic groups. Quantification of EBV load demonstrated no differences between the PTA and the elective tonsillectomy group, nor between the abscessed and non-abscessed tonsil of PTA patients. In summary, our data do not support a significant role for the examined viruses in the pathogenesis of PTA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Rusan M, Klug TE, Ovesen T (2009) An overview of the microbiology of acute ear, nose and throat infections requiring hospitalisation. Eur J Clin Microbiol Infect Dis 28(3):243–251. doi:10.1007/s10096-008-0619-y

    Article  PubMed  CAS  Google Scholar 

  2. Klug TE, Henriksen JJ, Fuursted K, Ovesen T (2011) Significant pathogens in peritonsillar abscesses. Eur J Clin Microbiol Infect Dis 30(5):619–627. doi:10.1007/s10096-010-1130-9

    Article  PubMed  CAS  Google Scholar 

  3. Ryan C, Dutta C, Simo R (2004) Role of screening for infectious mononucleosis in patients admitted with isolated, unilateral peritonsillar abscess. J Laryngol Otol 118(5):362–365. doi:10.1258/002221504323086552

    Article  PubMed  Google Scholar 

  4. Arkkila E, Sipila J, Laurikainen E, Suonpaa J (1998) Peritonsillar abscess associated with infectious mononucleosis. ORL J Otorhinolaryngol Relat Spec 60(3):159–163

    Article  PubMed  CAS  Google Scholar 

  5. Hanna BC, McMullan R, Gallagher G, Hedderwick S (2006) The epidemiology of peritonsillar abscess disease in Northern Ireland. J Infect 52(4):247–253. doi:10.1016/j.jinf.2005.07.002

    Article  PubMed  Google Scholar 

  6. Stenfors LE, Bye HM, Raisanen S (2003) Noticeable differences in bacterial defence on tonsillar surfaces between bacteria-induced and virus-induced acute tonsillitis. Int J Pediatr Otorhinolaryngol 67(10):1075–1082

    Article  PubMed  Google Scholar 

  7. Stenfors LE, Bye HM, Raisanen S (2001) Bacterial coating with immunoglobulins on the palatine tonsils during infectious mononucleosis: immunocytochemical study with gold markers. J Laryngol Otol 115(2):101–105

    Article  PubMed  CAS  Google Scholar 

  8. Stenfors LE, Bye HM, Raisanen S (2002) Causes for massive bacterial colonization on mucosal membranes during infectious mononucleosis: implications for acute otitis media. Int J Pediatr Otorhinolaryngol 65(3):233–240

    Article  PubMed  Google Scholar 

  9. Patel J, Faden H, Sharma S, Ogra PL (1992) Effect of respiratory syncytial virus on adherence, colonization and immunity of non-typable Haemophilus influenzae: implications for otitis media. Int J Pediatr Otorhinolaryngol 23(1):15–23

    Article  PubMed  CAS  Google Scholar 

  10. Bakaletz LO (1995) Viral potentiation of bacterial superinfection of the respiratory tract. Trends in Microbiology 3(3):110–114

    Article  PubMed  CAS  Google Scholar 

  11. Wald ER (2011) Acute otitis media and acute bacterial sinusitis. Clin Infect Dis 52(Suppl 4):S277–S283. doi:10.1093/cid/cir042

    Article  PubMed  Google Scholar 

  12. Rothberg MB, Haessler SD, Brown RB (2008) Complications of viral influenza. Am J Med 121(4):258–264. doi:10.1016/j.amjmed.2007.10.040

    Article  PubMed  Google Scholar 

  13. van Elden LJ, Nijhuis M, Schipper P, Schuurman R, van Loon AM (2001) Simultaneous detection of influenza viruses A and B using real-time quantitative PCR. J Clin Microbiol 39(1):196–200. doi:10.1128/JCM.39.1.196-200.2001

    Article  PubMed  Google Scholar 

  14. Pevenstein SR, Williams RK, McChesney D, Mont EK, Smialek JE, Straus SE (1999) Quantitation of latent varicella-zoster virus and herpes simplex virus genomes in human trigeminal ganglia. J Virol 73(12):10514–10518

    PubMed  CAS  Google Scholar 

  15. Ebner K, Suda M, Watzinger F, Lion T (2005) Molecular detection and quantitative analysis of the entire spectrum of human adenoviruses by a two-reaction real-time PCR assay. J Clin Microbiol 43(7):3049–3053. doi:10.1128/JCM.43.7.3049-3053.2005

    Article  PubMed  CAS  Google Scholar 

  16. Hu A, Colella M, Tam JS, Rappaport R, Cheng SM (2003) Simultaneous detection, subgrouping, and quantitation of respiratory syncytial virus A and B by real-time PCR. J Clin Microbiol 41(1):149–154

    Article  PubMed  CAS  Google Scholar 

  17. Niesters HG, van Esser J, Fries E, Wolthers KC, Cornelissen J, Osterhaus AD (2000) Development of a real-time quantitative assay for detection of Epstein-Barr virus. J Clin Microbiol 38(2):712–715

    PubMed  CAS  Google Scholar 

  18. Yoda K, Sata T, Kurata T, Aramaki H (2000) Oropharyngotonsillitis associated with nonprimary Epstein-Barr virus infection. Arch Otolaryngol Head Neck Surg 126(2):185–193

    PubMed  CAS  Google Scholar 

  19. Wat PJ, Strickler JG, Myers JL, Nordstrom MR (1994) Herpes simplex infection causing acute necrotizing tonsillitis. Mayo Clin Proc 69(3):269–271

    PubMed  CAS  Google Scholar 

  20. Grady D, McClung JE, Veltri RW, Sprinkle PM, Veach JS (1982) Association of Epstein-Barr virus with acute exudative tonsillitis. Otolaryngol Head Neck Surg 90(1):11–15

    PubMed  CAS  Google Scholar 

  21. Kohdera U, Kino M, Ito M (2006) Detection of adenovirus DNA in throat swabs and blood by SYBR green real-time PCR assay in patients with adenovirus-associated tonsillitis. Jpn J Infect Dis 59(6):394–396

    PubMed  CAS  Google Scholar 

  22. Piacentini GL, Peroni DG, Blasi F, Pescollderungg L, Goller P, Gallmetzer L, Drago L, Bodini A, Boner AL (2010) Atypical bacteria in adenoids and tonsils of children requiring adenotonsillectomy. Acta Oto-Laryngologica 130(5):620–625. doi:10.3109/00016480903359921

    Article  PubMed  Google Scholar 

  23. Drago L, Esposito S, De Vecchi E, Marchisio P, Blasi F, Baggi E, Capaccio P, Pignataro L (2008) Detection of respiratory viruses and atypical bacteria in children's tonsils and adenoids. J Clin Microbiol 46(1):369–370. doi:10.1128/JCM.01819-07

    Article  PubMed  Google Scholar 

  24. Hug M, Dorner M, Frohlich FZ, Gysin C, Neuhaus D, Nadal D, Berger C (2010) Pediatric Epstein-Barr virus carriers with or without tonsillar enlargement may substantially contribute to spreading of the virus. J Infect Dis 202(8):1192–1199. doi:10.1086/656335

    Article  PubMed  Google Scholar 

  25. Sahin F, Gerceker D, Karasartova D, Ozsan TM (2007) Detection of herpes simplex virus type 1 in addition to Epstein-Bar virus in tonsils using a new multiplex polymerase chain reaction assay. Diagn Microbiol Infect Dis 57(1):47–51. doi:10.1016/j.diagmicrobio.2006.09.013

    Article  PubMed  CAS  Google Scholar 

  26. Vassallo J, Camargo LA, Chagas CA, Pinto GA, Endo LH (2005) Search for Herpesvirus 1 and 2 by in situ hybridization in tonsils and adenoids. Int J Pediatr Otorhinolaryngol 69(3):345–349. doi:10.1016/j.ijporl.2004.10.006

    Article  PubMed  Google Scholar 

  27. Hudnall SD, Ge Y, Wei L, Yang NP, Wang HQ, Chen T (2005) Distribution and phenotype of Epstein-Barr virus-infected cells in human pharyngeal tonsils. Mod Pathol 18(4):519–527. doi:10.1038/modpathol.3800369

    Article  PubMed  Google Scholar 

  28. Ikeda T, Kobayashi R, Horiuchi M, Nagata Y, Hasegawa M, Mizuno F, Hirai K (2000) Detection of lymphocytes productively infected with Epstein-Barr virus in non-neoplastic tonsils. J Gen Virol 81(Pt 5):1211–1216

    PubMed  CAS  Google Scholar 

  29. Berger C, Hug M, Gysin C, Molinari L, Frei M, Bossart W, Nadal D (2007) Distribution patterns of beta- and gamma-herpesviruses within Waldeyer's ring organs. J Med Virol 79(8):1147–1152. doi:10.1002/jmv.20899

    Article  PubMed  CAS  Google Scholar 

  30. Pai PC, Tsang NM, Tseng CK, Hao SP, Kuo TT, Wei KC, Hsueh C, Chuang CC (2004) Prevalence of LMP-1 gene in tonsils and non-neoplastic nasopharynxes by nest-polymerase chain reaction in Taiwan. Head Neck 26(7):619–624. doi:10.1002/hed.20057

    Article  PubMed  Google Scholar 

  31. Dias EP, Rocha ML, Carvalho MO, Amorim LM (2009) Detection of Epstein-Barr virus in recurrent tonsillitis. Braz J Otorhinolaryngol 75(1):30–34

    PubMed  Google Scholar 

  32. Endo LH, Ferreira D, Montenegro MC, Pinto GA, Altemani A, Bortoleto AE Jr, Vassallo J (2001) Detection of Epstein-Barr virus in tonsillar tissue of children and the relationship with recurrent tonsillitis. Int J Pediatr Otorhinolaryngol 58(1):9–15

    Article  PubMed  CAS  Google Scholar 

  33. Hesse J, Ibsen KK, Krabbe S, Uldall P (1983) Prevalence of antibodies to Epstein-Barr virus (EBV) in childhood and adolescence in Denmark. Scand J Infect Dis 15(4):335–338

    PubMed  CAS  Google Scholar 

  34. Kvestad E, Kvaerner KJ, Roysamb E, Tambs K, Harris JR, Magnus P (2005) Heritability of recurrent tonsillitis. Arch Otolaryngol Head Neck Surg 131(5):383–387. doi:10.1001/archotol.131.5.383

    Article  PubMed  Google Scholar 

  35. Marom T, Cinamon U, Itskoviz D, Roth Y (2010) Changing trends of peritonsillar abscess. Am J Otolaryngol 31(3):162–167. doi:10.1016/j.amjoto.2008.12.003

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors wish to thank Marianne Lund, Kurt Handberg, and Søren E. Degn for technical guidance.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Rusan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rusan, M., Klug, T.E., Henriksen, J.J. et al. The role of viruses in the pathogenesis of peritonsillar abscess. Eur J Clin Microbiol Infect Dis 31, 2335–2343 (2012). https://doi.org/10.1007/s10096-012-1573-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-012-1573-2

Keywords

Navigation