History: A 12-year-old boy presents with a sore throat, difficulty swallowing, inability to fully open his mouth, trismus, drooling, and a “hot-potato” voice. What is the diagnosis?
Answer: Peritonsillar abscess, aka quinsy is an accumulation of pus due to an infection behind the tonsil.
Symptoms: Fever, throat pain, trouble opening the mouth, and a change to the voice. Pain is usually worse on one side.
Complications: Blockage of the airway or aspiration pneumonitis, retropharyngeal abscess.
Cause: Commonly involved aerobic pathogens include Streptococcus, Staphylococcus, and Haemophilus. The most common anaerobic species include Fusobacterium necrophorum, Peptostreptococcus, Prevotella species, and Bacteroides.
Diagnosis: Medical imaging may include CT scan, MRI, or ultrasound.
Treatment: Antibiotics, volume repletion with fluids, and pain medication, in cases where airway obstruction or systemic sepsis occurs, surgical drainage may be necessary.