Peritonsillar Abscess
Medgeeks with Andrew Reid
Medgeeks
4.8 • 997 Ratings
🗓️ 23 November 2018
⏱️ 8 minutes
🧾️ Download transcript
Summary
I was doing some moonlighting the other week, and I had a textbook case walk through the door. However, it's a case that doesn't walk through the door all too often.
I had a 63 year old male with a history of hypertension and type 2 DM who presented with sore throat x 5 days. He denies shortness of breath and chest pain.
Vitals revealed normal temperature, HR 95, BP 145/80, and O2 sat 98% RA.
At first, I was thinking this is likely a simple URI and was ready to give tylenol for pain coupled with a prescription for rest and fluids.
As I walked in to greet the patient, I noticed there was clearly something wrong. He responded with a muffled voice as if he had a potato in his mouth.
So I did my exam...
...I'm excited to share this case with everyone and I hope you enjoy!
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Transcript
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| 0:00.0 | Teams, I care for med geeks. |
| 0:03.0 | So, I was doing some moonlighting in the ER a week ago, and I had a textbook case walk through the door. |
| 0:09.0 | However, one that doesn't walk through the door too often. So, at a 63 year old male had a history of |
| 0:16.5 | hypertension and type 2 diabetes presented with the chief complaint of sore throat. The |
| 0:22.3 | triage nurse note stated, |
| 0:24.4 | complains a sore throat for five days, no shortness of breath, no chest pain, poor appetite, |
| 0:29.6 | no prior visits in the chart for review. Vitals revealed no fever, heart rate 95, |
| 0:36.0 | blood pressure 145 over 80, and O2 saturation of 98% on room air. In my head I'm already thinking, okay, this is likely the common cold, |
| 0:46.1 | use Tylenol for fever, pain, and get some rest and fluids. I walked through the door, |
| 0:52.3 | introduce myself, and the patient responded. |
| 0:55.0 | However, to my surprise, it was clearly not his normal voice. |
| 0:59.0 | He had this muffled voice as if he had a potato in his mouth. I was amazed. I was like, this is |
| 1:06.7 | textbooked and the textbook was finally spot on. I mean the guy responded with, |
| 1:11.9 | her, my mouth has. I mean the guy responded with, hoor my moor hoor. |
| 1:15.0 | So I did my exam and as I expected |
| 1:18.0 | there was an aritheminous swollen tonsil |
| 1:21.0 | with uvular deviation. |
| 1:23.0 | So let us quickly review and break down the peritonsular abscess. |
| 1:28.0 | So introduction, peritonsular abscess is a deep neck infection that is defined as a collection of pus between the palatine |
| 1:36.0 | tonsil and the pharyngeal muscles. |
| 1:38.9 | Etiology, the most common organisms that you'll see is strep pyogenes. Other organisms include the mixed |
| 1:45.7 | oral pharyngeal flora such as staph, other strep flavors, homophilus influenza, and then |
... |
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