Peritonsillar abscess physical examination: Difference between revisions

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==Overview==
==Overview==
On physical examination, patients are usually acutely ill-looking and may have high [[temperature]], muffled voice (also called "hot potato voice"), [[contralateral]] deflection of the uvula, the [[tonsil]] is generally displaced [[inferiorly]] and [[medially]], facial [[swelling]], [[tonsillar abscess|tonsillar]] [[hypertrophy]],, [[trismus]], [[drooling]], [[tenderness]] of [[anterior]] neck and tender [[submandibular]] and [[anterior]] [[cervical lymph nodes|cervical lymph node.s]]<ref name="pmid18246890">{{cite journal| author=Galioto NJ| title=Peritonsillar abscess. | journal=Am Fam Physician | year= 2008 | volume= 77 | issue= 2 | pages= 199-202 | pmid=18246890 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18246890  }} </ref><ref>{{cite book | last = Ferri | first = Fred | title = Ferri's clinical advisor 2015 : 5 books in 1 | publisher = Elsevier/Mosby | location = Philadelphia, PA | year = 2015 | isbn = 978-0323083751 }}</ref><ref name="pmid8302122">{{cite journal| author=Passy V| title=Pathogenesis of peritonsillar abscess. | journal=Laryngoscope | year= 1994 | volume= 104 | issue= 2 | pages= 185-90 | pmid=8302122 | doi=10.1288/00005537-199402000-00011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8302122  }} </ref><ref name="pmid11127146">{{cite journal| author=Nwe TT, Singh B| title=Management of pain in peritonsillar abscess. | journal=J Laryngol Otol | year= 2000 | volume= 114 | issue= 10 | pages= 765-7 | pmid=11127146 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11127146  }} </ref>
On physical examination, patients are usually acutely ill-looking and may have high [[temperature]], muffled voice (also called "hot potato voice"), [[contralateral]] deflection of the [[uvula]], the [[tonsil]] is generally displaced [[inferiorly]] and [[medially]], facial [[swelling]], [[tonsillar abscess|tonsillar]] [[hypertrophy]], [[trismus]], [[drooling]], [[tenderness]] of [[anterior]] neck and tender [[submandibular]] and [[anterior]] [[cervical lymph nodes]]<ref name="pmid18246890">{{cite journal| author=Galioto NJ| title=Peritonsillar abscess. | journal=Am Fam Physician | year= 2008 | volume= 77 | issue= 2 | pages= 199-202 | pmid=18246890 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18246890  }} </ref><ref>{{cite book | last = Ferri | first = Fred | title = Ferri's clinical advisor 2015 : 5 books in 1 | publisher = Elsevier/Mosby | location = Philadelphia, PA | year = 2015 | isbn = 978-0323083751 }}</ref><ref name="pmid8302122">{{cite journal| author=Passy V| title=Pathogenesis of peritonsillar abscess. | journal=Laryngoscope | year= 1994 | volume= 104 | issue= 2 | pages= 185-90 | pmid=8302122 | doi=10.1288/00005537-199402000-00011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8302122  }} </ref><ref name="pmid11127146">{{cite journal| author=Nwe TT, Singh B| title=Management of pain in peritonsillar abscess. | journal=J Laryngol Otol | year= 2000 | volume= 114 | issue= 10 | pages= 765-7 | pmid=11127146 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11127146  }} </ref>


==Physical examination==
==Physical examination==
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* [[Rancidification|Rancid]] or [[Fetor oris|fetor]] breath
* [[Rancidification|Rancid]] or [[Fetor oris|fetor]] breath


The image below shows edematous and [[inflamed]]  tonsil on the right with [[contralateral]] [[uvula]] deviation:<ref name =abc>DescriptionEnglish: A right sided peritonsilar abscess Date 13 May 2011 Source Own work Author James Heilman,MD wikimedia commons https://commons.wikimedia.org/wiki/File:PeritonsilarAbsess.jpg</ref>
The image below shows edematous and [[inflamed]]  [[tonsil]] on the right with [[contralateral]] [[uvula]] deviation:<ref name =abc>DescriptionEnglish: A right sided peritonsilar abscess Date 13 May 2011 Source Own work Author James Heilman,MD wikimedia commons https://commons.wikimedia.org/wiki/File:PeritonsilarAbsess.jpg</ref>




[[Image:PTA2.jpg|200PX]]
[[Image:PTA2.jpg|200PX|center|thumb|By James Heilman,MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=15307040]]


====Neck====
====Neck====
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* May be in obvious [[respiratory distress]] with flaring of ala nasi, [[subcostal]] and [[intercostal]] recessions.
* May be in obvious [[respiratory distress]] with flaring of ala nasi, [[subcostal]] and [[intercostal]] recessions.
* Increased [[respiratory rate]] in both children and adults
* Increased [[respiratory rate]] in both children and adults
* Decreased air-entry depending of degree of [[airway obstruction]]
* Decreased air-entry depending on degree of [[airway obstruction]]


====Extremities====
====Extremities====
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{{WH}}
{{WH}}
{{WS}}
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[[Category:Emergency mdicine]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Otolaryngology]]
[[Category:Pediatrics]]
[[Category:Surgery]]

Latest revision as of 23:40, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]

Overview

On physical examination, patients are usually acutely ill-looking and may have high temperature, muffled voice (also called "hot potato voice"), contralateral deflection of the uvula, the tonsil is generally displaced inferiorly and medially, facial swelling, tonsillar hypertrophy, trismus, drooling, tenderness of anterior neck and tender submandibular and anterior cervical lymph nodes[1][2][3][4]

Physical examination

Physical examination findings suggestive of peritonsillar abscess include the following:[1][5][3][4]

Appearance of the Patient

  • They are usually acutely ill-looking.

Vital Signs

HEENT

The image below shows edematous and inflamed tonsil on the right with contralateral uvula deviation:[6]


By James Heilman,MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=15307040

Neck

Lungs

Extremities

References

  1. ↑ 1.0 1.1 Galioto NJ (2008). "Peritonsillar abscess". Am Fam Physician. 77 (2): 199–202. PMID 18246890.
  2. ↑ Ferri, Fred (2015). Ferri's clinical advisor 2015 : 5 books in 1. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323083751.
  3. ↑ 3.0 3.1 Passy V (1994). "Pathogenesis of peritonsillar abscess". Laryngoscope. 104 (2): 185–90. doi:10.1288/00005537-199402000-00011. PMID 8302122.
  4. ↑ 4.0 4.1 Nwe TT, Singh B (2000). "Management of pain in peritonsillar abscess". J Laryngol Otol. 114 (10): 765–7. PMID 11127146.
  5. ↑ Ferri, Fred (2015). Ferri's clinical advisor 2015 : 5 books in 1. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323083751.
  6. ↑ DescriptionEnglish: A right sided peritonsilar abscess Date 13 May 2011 Source Own work Author James Heilman,MD wikimedia commons https://commons.wikimedia.org/wiki/File:PeritonsilarAbsess.jpg

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