Bilateral peritonsillar abscesses: case report and literature review

Although unilateral peritonsillar abscesses (PTA) are a common complication of acute bacterial tonsillitis, bilateral PTA are quite rare. We present the case of a 14-year-old female teenager with a 1-week history of acute tonsillitis. Physical examination revealed significant trismus, symmetrically inflamed tonsils and soft palate, and a midline uvula. A contrast-enhanced CT scan of the neck demonstrated bilateral PTA. After bilateral needle aspiration and administration of antibiotics, complete disease resolution was rapidly achieved. Patients with bilateral PTA present a diagnostic dilemma because they do not demonstrate the classic asymmetric signs and symptoms seen in the more prevalent unilateral PTA. Contrast-enhanced CT imaging can help diagnose bilateral PTA and should be considered in the presence of marked trismus but with the absence of unilateral inflammatory findings.