ENT · Pharynx (Tonsils, Adenoids, Abscesses, NPC, JNA)

A 20-year-old presents with sore throat, trismus, uvular deviation to the left, and a bulge in the right peritonsillar area. The most likely diagnosis and the most appropriate immediate management are:

  • A Peritonsillar abscess (quinsy); needle aspiration or incision and drainage
  • B Retropharyngeal abscess; lateral neck drain
  • C Parapharyngeal abscess; external drainage
  • D Ludwig's angina; tracheostomy
Correct answer: A. Peritonsillar abscess (quinsy); needle aspiration or incision and drainage

Explanation

Peritonsillar abscess (quinsy) is the most common deep neck space infection, characterised by unilateral peritonsillar bulge, uvular deviation to the contralateral side, trismus, and 'hot potato' muffled voice. Treatment is needle aspiration (most practical first step) or incision and drainage plus intravenous penicillin. Interval tonsillectomy is advised after recurrent episodes.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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