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Tonsillar/Peritonsillar Abscess
H. Ric Harnsberger, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Tonsillar abscess (TA), peritonsillar abscess (PTA)
          • Synonyms

            • Intratonsillar abscess
            • Surgical term "peritonsillar abscess" varies from radiologic term
              • Surgical "peritonsillar" referring to loose connective tissue between palatine tonsil capsule and superior constrictor muscle
              • Radiologic term "peritonsillar" refers to pus that has involved surrounding deep spaces of suprahyoid neck
          • Definitions

            • Tonsillar abscess: Abscess within palatine tonsil
            • Peritonsillar abscess: TA spreads to adjacent spaces

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    • Radiographic Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          • Reporting Tips

                                            Selected References

                                            1. Ulualp SO et al: Management of intratonsillar abscess in children. Pediatr Int. 55(4):455-60, 2013
                                            2. Gonzalez-Beicos A et al: Imaging of acute head and neck infections. Radiol Clin North Am. 50(1):73-83, 2012
                                            3. Klug TE et al: Significant pathogens in peritonsillar abscesses. Eur J Clin Microbiol Infect Dis. 30(5):619-27, 2011
                                            4. Brook I: Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses. J Oral Maxillofac Surg. 62(12):1545-50, 2004
                                            5. Johnson BC et al: Cost-effective workup for tonsillitis. Testing, treatment, and potential complications. Postgrad Med. 113(3):115-8, 121, 2003
                                            6. Windfuhr J: Malignant neoplasia at different ages presenting as peritonsillar abscess. Otolaryngol Head Neck Surg. 126(2):197-8, 2002
                                            7. Holmes SB et al: Squamous cell carcinoma presenting as a peritonsillar abscess. Br J Oral Maxillofac Surg. 39(1):46-8, 2001
                                            8. Schraff S et al: Peritonsillar abscess in children: a 10-year review of diagnosis and management. Int J Pediatr Otorhinolaryngol. 57(3):213-8, 2001
                                            9. Fujimoto M et al: Immediate tonsillectomy for peritonsillar abscess. Acta Otolaryngol Suppl. 523:252-5, 1996
                                            10. Blokmanis A: Ultrasound in the diagnosis and management of peritonsillar abscesses. J Otolaryngol. 23(4):260-2, 1994
                                            11. Buckley AR et al: Diagnosis of peritonsillar abscess: value of intraoral sonography. AJR Am J Roentgenol. 162(4):961-4, 1994
                                            12. Patel KS et al: The role of computed tomography in the management of peritonsillar abscess. Otolaryngol Head Neck Surg. 107(6 Pt 1):727-32, 1992
                                            13. Brodsky L et al: A clinical prospective study of peritonsillar abscess in children. Laryngoscope. 98(7):780-3, 1988
                                            14. Spires JR et al: Treatment of peritonsillar abscess. A prospective study of aspiration vs incision and drainage. Arch Otolaryngol Head Neck Surg. 113(9):984-6, 1987
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Tonsillar abscess (TA), peritonsillar abscess (PTA)
                                                    • Synonyms

                                                      • Intratonsillar abscess
                                                      • Surgical term "peritonsillar abscess" varies from radiologic term
                                                        • Surgical "peritonsillar" referring to loose connective tissue between palatine tonsil capsule and superior constrictor muscle
                                                        • Radiologic term "peritonsillar" refers to pus that has involved surrounding deep spaces of suprahyoid neck
                                                    • Definitions

                                                      • Tonsillar abscess: Abscess within palatine tonsil
                                                      • Peritonsillar abscess: TA spreads to adjacent spaces

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Imaging Recommendations

                                                              • Radiographic Findings

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Consider

                                                                                  • Image Interpretation Pearls

                                                                                    • Reporting Tips

                                                                                      Selected References

                                                                                      1. Ulualp SO et al: Management of intratonsillar abscess in children. Pediatr Int. 55(4):455-60, 2013
                                                                                      2. Gonzalez-Beicos A et al: Imaging of acute head and neck infections. Radiol Clin North Am. 50(1):73-83, 2012
                                                                                      3. Klug TE et al: Significant pathogens in peritonsillar abscesses. Eur J Clin Microbiol Infect Dis. 30(5):619-27, 2011
                                                                                      4. Brook I: Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses. J Oral Maxillofac Surg. 62(12):1545-50, 2004
                                                                                      5. Johnson BC et al: Cost-effective workup for tonsillitis. Testing, treatment, and potential complications. Postgrad Med. 113(3):115-8, 121, 2003
                                                                                      6. Windfuhr J: Malignant neoplasia at different ages presenting as peritonsillar abscess. Otolaryngol Head Neck Surg. 126(2):197-8, 2002
                                                                                      7. Holmes SB et al: Squamous cell carcinoma presenting as a peritonsillar abscess. Br J Oral Maxillofac Surg. 39(1):46-8, 2001
                                                                                      8. Schraff S et al: Peritonsillar abscess in children: a 10-year review of diagnosis and management. Int J Pediatr Otorhinolaryngol. 57(3):213-8, 2001
                                                                                      9. Fujimoto M et al: Immediate tonsillectomy for peritonsillar abscess. Acta Otolaryngol Suppl. 523:252-5, 1996
                                                                                      10. Blokmanis A: Ultrasound in the diagnosis and management of peritonsillar abscesses. J Otolaryngol. 23(4):260-2, 1994
                                                                                      11. Buckley AR et al: Diagnosis of peritonsillar abscess: value of intraoral sonography. AJR Am J Roentgenol. 162(4):961-4, 1994
                                                                                      12. Patel KS et al: The role of computed tomography in the management of peritonsillar abscess. Otolaryngol Head Neck Surg. 107(6 Pt 1):727-32, 1992
                                                                                      13. Brodsky L et al: A clinical prospective study of peritonsillar abscess in children. Laryngoscope. 98(7):780-3, 1988
                                                                                      14. Spires JR et al: Treatment of peritonsillar abscess. A prospective study of aspiration vs incision and drainage. Arch Otolaryngol Head Neck Surg. 113(9):984-6, 1987