Bilateral peritonsillar abscess

Case contributed by Jia Han Chang


4 days odynophagia. History of recurrent tonsillitis.

Patient Data

Age: 30 years
Gender: Male

Bilateral peritonsillar abscess.

Minimal fat stranding in the right parapharyngeal space. No deep space collection.

Prominent nodes in the jugulodigastric chain bilaterally.

Airway is patent.

Case Discussion

Patient successfully managed conservatively with antibiotics and steroid course. He is referred to ENT clinic for consideration of tonsillectomy.

Peritonsillar abscess is a recognized complication of tonsillitis. Drainage is done either by needle aspiration or by incision. Emergent tonsillectomy is rarely performed.

In general patients who have developed peritonsillar abscess are at higher risk of recurrence of future episodes of peritonsillar abscesses (11% risk after first episode, and risk increases with each recurrence). Therefore they are offered tonsillectomy as prevention.

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