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peritonsillar abscess
Etiology:
1) occurs as a complication of bacterial tonsillitis
2) group A Streptococcus (45%)
3) anaerobes (18%)
4) may be coinfection
Epidemiology:
- most common deep neck infection in adults
Clinical manifestations:
1) increasing sore throat, worsening pharyngitis
2) fever
2) unilateral otalgia
3) eventual development of
a) dysarthria
b) trismus (lockjaw)
c) tender fluctuant mass
- described as unilateral edema & erythema of tonsil [NEJM]
d) muffled voice
e) deviation of the uvula
4) medially displaced tonsil
Management:
1) needle aspiration by an otolaryngologist
- incision & drainage is an alternative
2) penicillin
3) clindamycin
Related
palatine tonsil (faucial tonsil, tonsilla)
tonsillitis
General
abscess
upper respiratory tract infection (URI, common cold)
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Akhavan M.
Ear, Nose, Throat: Beyond Pharyngitis: Retropharyngeal Abscess,
Peritonsillar Abscess, Epiglottitis, Bacterial Tracheitis, and
Postoperative Tonsillectomy.
Emerg Med Clin North Am. 2021 Aug;39(3):661-675.
PMID: 34215408 Review.
- NEJM Knowledge+ Otolaryngology