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Bilateral Peritonsillar Abscess in an Infant: An Unusual Presentation of Sore Throat
Mariana Manzoni Seerig1, Letícia Chueiri1, Janaina Jacques1
1Department of Otolaryngology, Hospital Infantil Joana de Gusmão and Hospital Governador Celso Ramos, 152 Rui Barbosa St., 88025-301 Florianópolis, SC, Brazil.
Insights
Bilateral peritonsillar abscess is rare in infants. This case highlights the importance of prompt diagnosis and treatment in young children to prevent complications.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
Background:
- Peritonsillar abscess, a complication of acute tonsillitis, is typically unilateral.
- Bilateral peritonsillar abscesses are uncommon, particularly in infants.
- This condition usually affects older children and young adults.
Observation:
- A 1-year-old infant presented with sore throat, appetite loss, vomiting, and fever.
- Physical examination revealed enlarged tonsils and a bilaterally bulging soft palate.
- CT scan confirmed bilateral peritonsillar abscess.
Findings:
- Initial antibiotic therapy showed limited improvement.
- Surgical drainage of the bilateral abscesses was performed.
- The infant showed good clinical and laboratory recovery post-procedure.
Implications:
- Bilateral peritonsillar abscess requires prompt diagnosis and management in infants.
- Early intervention is crucial to prevent airway obstruction and deep neck space infections.
- Treatment strategies for pediatric bilateral peritonsillar abscess warrant further consideration.
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.
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