Peritonsillar Abscess

HISTORY:

‍Sore throatDifficulty swallowing for ‍ ‍hoursdays

Severity: ‍mildmoderatesevere, ‍012345678910 / 10

Radiation: ‍none

Worsening factors: ‍noneswallowing

Treatments tried: ‍none, ‍effectiveineffective

Contact with strep throat: ‍yesno

‍difficulty swallowing

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills

‍muffled voice

‍drooling

‍headache

‍neck pain

‍swelling in throat

‍inability to open mouth fully

‍shortness of breath

‍feeling of choking



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Eyes: -R: ‍normal, -L: ‍normal, ‍

Ears: -R: ‍normal, -L: ‍normal

Nose: ‍normal

Throat: ‍normalrednessexudate

Neck: ‍normallymphadenopathy

Heart: ‍RRR, ‍normal S1 and S2

Lungs: ‍clearabnormal sounds, ‍retractions

Skin: ‍no rash



ASSESSMENT:

‍Peritonsillar abscess ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Throat swab

- Blood work: ‍CBC, ‍CRP, ‍electrolytes, ‍creatinine, ‍blood cultures, ‍ß-hCG

- CT scan of the neck

- Ultrasound of the neck

- ‍Antibiotics

- ‍Acetaminophen

- ‍NSAIDs

- ‍Opioids

- Dexamethasone 10mg po once

- Incision and drainage

- Hydration and rest

- Limit contact with others

- Referral to ENT specialist

- Follow-up in ‍ ‍daysweeks

- Return if symptoms worsen or if new symptoms develop such as difficulty breathing, difficulty swallowing, or fever

- Go to ER if severe throat pain, severe difficulty swallowing, or high fever occurs