DATE
August 10, 2023
CATEGORY
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ABSTRACT
The case describes the anatomy and pathophysiology of the palatine tonsils and the development of intratonsillar abscess. The abscess can be caused by a suppurative focus that arises in acute tonsillitis when outward drainage is prevented, leading to pus accumulation in the tonsillar tissue. Dehydration or a history of peritonsillar abscess can also lead to Intratonsillar abscess. The condition can be mistaken for tonsillolith or malignancy, such as lymphoma.
A computed tomography (CT) scan is recommended for diagnosis, showing a low-density and ring enhancement. Aspiration using a large bore needle is the preferred mode of treatment, but if repeated aspirations fail, tonsillectomy may be necessary.
Intratonsillar abscess is rare and so far only 29 cases have been reported.1 The differential diagnoses include lymphoma, which usually presents as unilateral enlargement of the tonsil, tonsillolith due to its appearance and peritonsillar abscess again due to the unilateral enlargement of the tonsil. This case is different as compared to other reported cases we did not do a CT scan as recommended by most of the studies (cost being a concern). Also, in this case, we resorted to surgery as the main modality unlike other cases wherein the surgeons opted to do an aspiration of the pus mainly keeping the intraoperative complications in mind.
Keywords: Intratonsillar abscess, chronic tonsillitis, quinsy, aspiration, tonsillectomy
*ENT Surgeon, Dept. of ENT
†Anesthesiologist, Dept. of Anesthesiology
Pandit General Hospital, Sirsi, Uttara Kannada, Karnataka, India
‡Pathologist, Dept. of Pathology, Marikamba Hospital, Sirsi, Uttara Kannada,
Karnataka, India
Address for correspondence
Dr S Vinayak Easweran
ENT Surgeon, Dept. of ENT, Pandit General Hospital, Sirsi, Uttara Kannada, Karnataka, India
E-mail: vinoo121071@gmail.com
Indian Journal of Clinical Practice, Vol. 34, No. 1, June 2023