Presentation
An unwell patient, with right facial and neck pain and swelling. There is associated fever and odynophagia.
Patient Data
There is an irregular, lobulated, right-sided, peritonsillar abscess, measuring 21.1 x 11.0 mm (AP x width). There is mild ring enhancement and a low-density appearance consistent with pyogenic sepsis. There is an inferior extension with an inferomedial component measuring 19.0 x 10.2 mm (AP x width) and consequent asymmetric attenuation of the right pyriform fossa. There is an associated retropharyngeal effusion. CT significant and insignificant reactive, bilateral level 1A, 1B, 2A, and 2B lymph nodes. There are no necrotic nodes and no nodal abscesses.
There are incidental mental spines.
There is near total resolution of the right peritonsillar abscess with minimal supra-glottic heterogeneity. The reactive lymph adenopathy is also improved.
Case Discussion
Features consistent with a unilateral, peritonsillar abscess(quinsy) in an adult patient. Peritonsillar abscesses are often treated surgically. In this instance, the patient was managed conservatively on intravenous antibiotics and analgesia. The follow-up CT scan confirmed significant radiological resolution concordant with clinical improvement, obviating the need for surgical intervention.
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