A 25-year-old man presents with high-grade fever, severe sore throat, drooling of saliva, difficulty opening the mouth, and a bulge in the right peritonsillar region pushing the uvula to the left. He has been symptomatic for 4 days. What is the most appropriate immediate management?

• A Incision and drainage of the peritonsillar abscess ✓
• B Oral antibiotics for 10 days and re-evaluate
• C Intravenous steroids and admission for observation
• D Emergency tracheostomy

Explanation

The clinical findings of fluctuant peritonsillar bulge, uvular deviation, trismus, and systemic sepsis are diagnostic of peritonsillar abscess (quinsy). Incision and drainage (or needle aspiration) is the treatment of choice, performed under local anaesthesia. Antibiotics alone are insufficient for an established abscess. Tracheostomy is only needed if airway is compromised, which is not indicated here. Interval tonsillectomy is offered after the acute episode resolves.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.