Presentation
Worsening dysphagia and odynophagia. Also complains of muffled voice and shortness of breath. Evaluate for abscess.
Patient Data
There is an expansile low attenuating area in the right peritonsillar region that demonstrates faint peripheral enhancement. There is surrounding soft tissue oedema that extends superiorly into the right posterior nasopharynx to the region of the torus tubarius, and along the right posterolateral wall of the oropharynx extending to the right piriform sinus and right paraglottic fat.
There is enlargement of both palatine tonsils. There is very minimal oedema about the right side of the retropharynx, but no significant retropharyngeal collection is identified. There is some stranding within the right parapharyngeal fat, which may be related to cellulitis.
There is cervical lymphadenopathy within the bilateral neck zones II and III.
Case Discussion
This is a case of a right peritonsillar abscess.
The patient was evaluated by otolaryngology, who performed needle drainage of the collection. Microbiology was positive for Group A Beta haemolytic Streptococci (Streptococcus pyogenes).
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