Simultaneous bilateral peritonsillar abscess in an adolescent

Abstract

Aim of the study: The aim of this case report is to emphasise the importance of meticulous history-taking and examination, and to raise the awareness of various possibilities of diagnosis and management. Unilateral peritonsillar abscess is a common complication of acute bacterial tonsillitis. However, bilateral peritonsillar abscess is considered rare, and only a meagre number of cases has been reported to date in the English medical literature. The challenging part involved in the diagnosis of bilateral peritonsillar abscess is the absence of common physical findings of unilateral peritonsillar abscess. Case report: We present a case of a teenage girl who presented with a history of worsening sore throat, odynophagia and muffled voice, which turned out to be bilateral peritonsillar abscess. Oropharyngeal examination revealed bilateral peritonsillar fullness, and pus was aspirated bilaterally. The patient underwent bilateral peritonsillar incision and drainage, and was discharged well after a few days, with no recurrence. Bilateral peritonsillar abscess can present with usual symptoms, but physical findings may vary. Conclusion: Proper history-taking and meticulous physical examination may direct the physician towards correct diagnosis, and an imaging evaluation is warranted if in doubt, so as to avoid unwanted perilous complications.