Quinsy treated by aspiration: the volume of pus at initial aspiration is an accurate predictor of the need for subsequent re‐aspiration

Abstract

The aim of this study was to determine an accurate indicator of the need for second aspiration of peritonsillar abscesses the day after initial aspiration. A tertiary otolaryngology care centre. Fifty patients aged between 11 and 49 years with suspected peritonsillar abscess. A prospective case series. The potential indicators investigated included volume of pus at initial aspiration and clinical indicators suggesting persistent pus (dysphagia, odynophagia and trismus). The outcome measure was the presence of pus at subsequent aspiration. A linear correlation was found between volume of first aspirate and presence of pus on re-aspiration (r = 0.9753). A volume of pus <3 mL on initial aspiration accurately predicted <0.5 mL pus on re-aspiration. Sixty-four per cent (32) patients had 3 mL or more pus on initial aspiration and in all there was at least 1 mL or more pus on second aspiration. Clinical indicators correlated less well, with a average coefficient on first aspiration of 0.62 and on second aspiration of 0.35. The volume of pus on initial aspiration is a very reliable indicator in assessing the need for re-aspiration of peritonsillar abscesses. If 3 mL or more of pus are aspirated on the first occasion these patients should be seen the next day and have a further aspiration. Clinical symptoms and signs are not useful indicators.