Bilateral peritonsillar abscesses
Sore throat, fever, odynophagia.
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Bilateral hypodense collections with peripheral enhancement in the peritonsillar spaces. The tonsils are anteriomedially displaced.
Severe oropharyngeal obstruction.
Right lateral retropharyngeal and level IIA reactive nodes.
Peritonsillar abscess (or quinsy) is a collection of pus in the peritonsillar space between the tonsillar capsule and the superior constrictor muscle.
Peritonsillar abscess usually occurs following acute tonsillitis. Cultures most commonly reveal group A-Beta hemolytic streptococcus. It is commoner among the adolescent population. Bilateral disease is less common.
The exact pathophysiology of peritonsillar abscess formation remains unknown. The most accepted theory is that an infection develops in crypta magna that then spreads beyond the confines of the tonsillar capsule, initially causing peritonsillitis and then developing into peritonsillar abscess.