Peritonsillar abscess – What are the signs and symptoms, relevant dDx., sequelae, work up, and treatment options?

Peritonsillar abscess is cellulitis of the space behind the tonsillar capsule extending onto the soft palate, usually associated with Group A streptococcus.

Sn. & Sx.:

• Triad: trismus, uvular deviation, severe dysphagia
• Fever and dehydration
• Edema of the soft palate

dDx.:

• Streptococcal or viral pharyngitis
• Infectious mononucleosis
• Tonsillitis
• Peritonsillar abscess
• Leukemia
• Hodgkin’s disease

Sequelae:

• Airway obstruction
• Aspiration pneumonia secondary to rupture

Work up:

• Clinical examination

Tx.:

• Aspiration and drainage of the abscess
• IV antibiotics (penicillin)

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This post was written by Omar Rifai