Tonsillitis - kissing tonsils

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Follow up of left tonsillar abscess after medical treatment

Patient Data

Age: 30 years
Gender: Male
mri

Symmetrical enlargement of both palatine tonsils, reaching 3 x 3 x 4.5 cm, touching in the midline and encroaching on the oropharyngeal airway (kissing tonsils).

Marked regression of the left intra-tonsillar abscess, now a pinpoint focus measuring 5 mm.

No parapharyngeal space involvement. Regional cervical reactive lymphadenitis. All the other neck spaces are normal.

Case Discussion

Imaging features are characteristic for tonsillitis with the kissing tonsils appearance. Acute tonsillitis is a clinical diagnosis and usually doesn't need further imaging unless concern of a tonsillar/peritonsillar abscess or suspicion for another diagnosis like malignancy (e.g lymphoma).

In this case, the patient had a history of left tonsillar abscess on treatment which showed marked regression.

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