A young man with fever and throat pain

Abstract

A 32-year-old male, previously healthy, came to the emergency department complaining of fever, cough, and sore throat for two days. His vital signs revealed a 38.7 C temperature, pulse rate of 107/min, and respiratory rate of 24/min. Examination of the throat showed bilateral tonsillar erythema with enlargement and swelling of the left tonsil and deviated uvula to the right side (figure 1 A & B). Thus, analgesia and antipyretics were commenced. His blood tests revealed a WBC of 14 (range 4–11) ×109/L and C reactive protein of 108 (0–5) mg/l. An ultrasound (US) of the affected tonsil with an endocavity probe confirmed abscess collection with the carotid artery close to the inferior segment (figure 2). Thus, a diagnosis of the peritonsillar abscess was confirmed. Consequently, the diagnosis was explained to the patient, and consent was taken for abscess aspiration under local anesthesia. Aspiration was done using an 18 G needle with a plastic cap on and sawed at 1 cm to guard and prevent the needle's deep penetration. The needle was pointed to the superior segment, and 3-4 ml of pus was aspirated. Besides, antibiotics were given, and the patient was discharged to follow with the otolaryngology clinic.

Keywords

• fever
• throat pain
• peritonsillar abscess

References

1. 1- "Tonsillar Cellulitis and Tonsillar Abscess - Ear, Nose, and Throat Disorders - Merck Manuals Consumer Version". Merck Manuals Consumer Version. October 2017.
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