Presentation
Left sided quinsy drained repeatedly. Worsening swelling, dysphagia and neck pain. Febrile.
Patient Data
Fluid and gas in the left faucial tonsil. This collection extends down the pharyngeal mucosal space to the left pyriform sinus / hypopharynx with posterior extension into the retropharyngeal space with a large enhancing and gas containing collection. Inferior extension in the visceral space between the trachea and thyroid on the left.
No distinct mediastinal collection.
Case Discussion
An extensive trans-spatial collection, originating from a tonsillar infection. Examination in all planes demonstrates that all these spaces are contiguous with each other and why it is important to understand deep space anatomy when reporting acutely.
This case was managed with further needle aspiration of the tonsillar component, with intravenous fluid, antibiotic and steroid support.
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