A 40-year-old male presents with a 24-hour history of progressive difficulty swallowing, drooling, muffled voice, and trismus (difficulty opening his ...

Question

A 40-year-old male presents with a 24-hour history of progressive difficulty swallowing, drooling, muffled voice, and trismus (difficulty opening his mouth). He has a swollen left tonsil that appears to be pushing the uvula to the right. He has a temperature of 39°C. What is the most likely diagnosis and what is the airway concern?

Accepted Answer

Peritonsillar abscess (quinsy) - the swelling can progress to cause airway obstruction; urgent ENT referral for drainage is needed; the trismus makes intubation extremely difficult if the airway is compromised

Answer

Epiglottitis - immediate intubation is required

Answer

Ludwig's angina - this always affects the floor of the mouth

Answer

Simple tonsillitis - prescribe oral antibiotics

Answer

Oral cancer - urgent but not emergent

uk-dipimc MCQ (SBA): Peritonsillar Abscess - Airway Concern