Bilateral Peritonsillar Abscess: Navigating Diagnostic Challenges and
Optimizing Management for Favourable Outcomes
Abstract
Peritonsillar abscesses (PTAs), colloquially termed quinsy, are a
frequent complication of tonsillitis, typically presenting unilaterally
with distinctive clinical features. However, bilateral PTAs, though
rare, pose diagnostic complexities due to their atypical manifestations.
This study discusses a 15-year-old patient’s case with bilateral PTA and
conducts a thorough review of 28 documented cases of bilateral PTAs,
outlining clinical features, management options, and outcomes. Most
bilateral PTA occurrences were observed in male patients across a broad
age spectrum. Notably, some cases showed a positive association with
acute Epstein-Barr virus (EBV) infection. Various drainage techniques,
including incision and drainage, needle aspiration, and tonsillectomy,
were employed, each demonstrating effectiveness in different scenarios.
Systemic antibiotics targeting group A β-hemolytic streptococci and
anaerobes were frequently administered as adjunctive therapy. The study
underscores the importance of early consideration and swift surgical
intervention, especially in septic individuals lacking uvula
dislocation. Routine EBV serology is recommended during diagnosis to
inform treatment decisions accurately. While successful outcomes were
observed in all reviewed cases, caution is advised regarding potential
complications of deep neck abscesses, necessitating vigilant management.