A 5-year-old boy presents with high fever, sore throat, and muffled 'hot potato' voice. Examination reveals severe trismus, marked unilateral swelling of the left peritonsillar area with deviation of the uvula to the right. What is the diagnosis?
Answer and explanation
Correct answer: A. Peritonsillar abscess (quinsy)
- Step 1: Identify key signs: Unilateral tonsillar swelling, trismus (inability to open mouth due to pterygoid spasm), and uvular deviation away from the affected side.
- Step 2: This constellation is diagnostic of a peritonsillar abscess (quinsy), requiring needle aspiration or incision and drainage plus antibiotics.
Answer
Peritonsillar abscess (quinsy).
Why not the others: 'Viral pharyngitis' produces bilateral pharyngeal erythema without uvular deviation or trismus; 'Retropharyngeal abscess' presents with midline posterior pharyngeal bulging and neck stiffness/torticollis; 'Epiglottitis' presents with tripod positioning and drooling.
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