Bilateral Peritonsillar Abscess in an Infant: An Unusual Presentation of Sore Throat

Abstract

Introduction Peritonsillar abscess is considered a suppurative complication of acute tonsillitis. It is usually unilateral and clinically evident bilateral presentation is uncommon. The condition affects mainly children older than 10 years and young adults. Herein we present a rare case of bilateral peritonsillar abscess in an infant. Presentation of Case A 1-year-old boy presented with a two-day history of worsening sore throat, loss of appetite, vomiting, and fever. Examination of the oral cavity and oropharynx revealed enlarged and inflamed tonsils and a bilaterally congested and bulging soft palate. CT scan confirmed the hypothesis of bilateral peritonsillar abscess. Antibiotic therapy was instituted and after 5 days only slight regression of swelling of the soft palate was observed. He underwent a surgical procedure for draining the abscesses. After the procedure, he presented good clinical and laboratory evolution and was discharged home. Discussion Although peritonsillar abscesses are considered common complications of acute tonsillitis bilateral cases are extremely rare, especially in early childhood. The diagnosis is based on history and physical examination and the treatment remains controversial among otolaryngologists. Conclusion Bilateral peritonsillar abscess should be diagnosed and treated promptly and adequately to prevent respiratory obstruction and to avoid dissemination into the deep neck spaces.

Absceso periamigdalino bilateral en pediatría: reporte de un caso

“…La bibliografía se limita a reporte de casos. 1,4,[7][8][9][10] Se ha informado con mayor frecuencia (el 1,9-24 %) el hallazgo de una colección contralateral, no manifiesta clínicamente, durante amigdalectomías "en caliente" realizadas por abscesos unilaterales. Se postula que este hallazgo puede corresponderse a diferentes momentos evolutivos de la patología presente en ambos espacios periamigdalinos.…”

Acute Tonsillitis in Children: The Principle “Zap and It’s Done!”?

“…Однако инвазивные формы, как правило, более тяжелые и возникают чаще у детей младшего воз-раста [23]. Гнойные осложнения, наоборот, в основном встречаются у детей старше 10 лет или молодых взрослых [24,25].…”

Case Report: Bilateral peritonsillar abscess with complications of upper airway obstruction

“…1,2 The prevalence of peritonsillar abscess is approximately 1.9% to 24% of tonsillectomy cases since abscess is also exists on the contralateral side. 2,3 The comprehensive report of bilateral peritonsillar abscess incidents reaches 4.9%. 1,2,4 Peritonsillar abscess patient age ranges from 10 to 40 years old, with an average of 27 to 28 years old.…”

“…The treatment includes incision and drainage of bilateral peritonsillar abscess and also appropriate medications. 2,3,5 This paper reports the clinical experiences and management of a bilateral peritonsillar abscess patient.…”