Lingual tonsillitis

Case contributed by Craig Hacking
Diagnosis almost certain

Presentation

Sore throat and fever. Anterior neck tenderness. 2 weeks post COVID infection. Concern of tracheitis and retropharyngeal abscess.

Patient Data

Age: 45 years
Gender: Female
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Enlarged, hyperenhancing lingual tonsil extending into the vallecula and depressing the epiglottis. Irregular mucosal surface with no associated collection. Mild stranding within the pre-epiglottic fat. Asymmetric oedema of the aryepilottic folds (left greater than right), trace prevertebral oedema and multiple prevertebral lymph nodes. Overall, the changes result in mild narrowing of the hypopharynx and supraglottic airway. No narrowing of the glottis and subglottic airway.

Case Discussion

The patient was negative for EBV, RSV, influenza A and B and settled well with symptom relief. The presumed diagnosis was COVID tonsillitis which has been reported in the literature.

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