Bilateral peritonsillar abscesses: not your usual sore throat.
We describe a rare case of a previously healthy 30-year-old man who presented to the Emergency Department (ED) with bilateral peritonsillar abscesses. The clinical presentation of fever, trismus and odynophagia was consistent with pertonsillar abscess (PTA), but the presence of symmetric tonsillar swelling and midline uvula confounded the diagnosis. The true incidence of bilateral peritonsillar abscesses is unknown, but the incidence of unsuspected contralateral peritonsillar abscess identified at tonsillectomy has been reported to be between 1.9% and 24%. The diagnosis of bilateral peritonsillar abscesses should be considered when the clinical presentation suggests the diagnosis of PTA, but the physical examination reveals bilateral swollen tonsils with a midline uvula.
Fasano
Charles J
CJ
Department of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania 19141, USA.
Chudnofsky
Carl
C
Vanderbeek
Paul
P
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D003680:Deglutition Disorders / Q000209:etiology; D003907:Dexamethasone / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009333:Neck / Q000000981:diagnostic imaging; D000039:Peritonsillar Abscess / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D010612:Pharyngitis / Q000209:etiology*; D011859:Radiography; D013290:Streptococcal Infections / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D013291:Streptococcus / Q000302:isolation & purification
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D002981:Clindamycin; D003907:Dexamethasone