Peritonsillar abscess

Question 1

presents with

Answer 1

severe unilateral throat pain, muffled hot potato vice, drooling, trismus, CONTRALATERAL DEVIATION OF UVULA, may present with airway obstruction or sepsis

Question 2

when will peritonsillar abscess progress to airway obstruction

Answer 2

if it extends to adjacent fascial compartments of the head or neck

Question 3

pathophys of peritonsillar abscess

Answer 3

unknown but thought to be a exudative tonsillitis turned abscess

Question 4

number 1 bug for peritonsillar abscess

Answer 4

GAS

Question 5

are anaerobes involved in peritonsillar abscess

Answer 5

yes

Question 6

1/3 of cases are found at what stage of life

Answer 6

childhood

Question 7

history

Answer 7

tonsillopharyngitis followed by worsening unilateral pharyngeal pain and high fevers
trismus
asymmetric throat fullness
worsening odynophagia and dysphagia
halitosis

Question 8

reconsider diagnosis if

Answer 8

infection persists despite abx bc remember GAS causes this and has no resistance to pcn

Question 9

evaluation first line

Answer 9

Intraoral u/s

Question 10

evaluation mechanisms aside from intraoral U/S

Answer 10

rapid strep test/throat culture
CT with IV contrast
ENT consult

Question 11

managing

Answer 11

• I and D
• IV hydration
• antipyretics and analgesics
• IV abx like ampicillin-sulbactam
• consider MRSA and possibly use IV vancomycin

Question 12

what is controversional in managing this

Answer 12

steroid use

Question 13

monitor patient closely for what

Answer 13

signs of airway obstruction