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Peritonsillar abscess

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Left sided neck pain and swelling, odynophagia and fever

Patient Data

Age: 54
Gender: Male
ct

Asymmetrically enlarged left palatine tonsil with an inferior hypodensity with peripheral enhancement that measures 14 x 9 x 16mm. There is associated tonsillar calcific foci. Edema extends inferiorly to efface the left vallecula.

Adjacent left parapharyngeal fat stranding. Asymmetric prominent/mildly enlarged left cervical lymph nodes. Retropharyngeal space has a normal appearance. Lung apices are clear. Carotid arteries and jugular veins opacify normally. No destructive bone lesion identified.

Conclusion:

Left-sided tonsillitis with peritonsillar abscess.

Case Discussion

Most causes of tonsillitis are simple but they can be complicated by the formation of peritonsillar or retropharyngeal abscess. 

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