Which condition presents with asymmetric swelling of peritonsillar tissue and uvular deviation away from the affected side, with symptoms such as sore throat, drooling, 'hot potato' voice, and trismus?

Which condition presents with asymmetric swelling of peritonsillar tissue and uvular deviation away from the affected side, with symptoms such as sore throat, drooling, 'hot potato' voice, and trismus?

• A. Acute tonsillitis
• B. Peritonsillar abscess
• C. Mononucleosis
• D. Pharyngitis

Answer: (B)

The main idea is that a localized infection in the peritonsillar space causes a unilateral, fluctuant swelling that shifts the uvula away from the affected side. This unilateral mass effect on the soft palate and tonsil produces the classic signs: asymmetric swelling, uvular deviation away from the swollen side, severe throat pain, drooling, a muffled or “hot potato” voice, and often trismus from involvement of nearby muscles. This pattern helps distinguish a peritonsillar abscess from other sore throat conditions. Acute tonsillitis can cause throat pain and fever but usually shows symmetric tonsillar enlargement without a fluctuating unilateral lump or uvular deviation. Mononucleosis can present with exudative pharyngitis and systemic symptoms like fatigue and lymphadenopathy, but it lacks the focal peritonsillar abscess signs. Pharyngitis is inflammation of the pharynx without the localized, pus-filled pocket and the accompanying uvular deviation and muffled voice. Because this is an emergency, management centers on securing the airway if needed, adequate analgesia and hydration, IV antibiotics covering oral flora and anaerobes, and drainage of the abscess via needle aspiration or incision and drainage by urgency.

The main idea is that a localized infection in the peritonsillar space causes a unilateral, fluctuant swelling that shifts the uvula away from the affected side. This unilateral mass effect on the soft palate and tonsil produces the classic signs: asymmetric swelling, uvular deviation away from the swollen side, severe throat pain, drooling, a muffled or “hot potato” voice, and often trismus from involvement of nearby muscles.

This pattern helps distinguish a peritonsillar abscess from other sore throat conditions. Acute tonsillitis can cause throat pain and fever but usually shows symmetric tonsillar enlargement without a fluctuating unilateral lump or uvular deviation. Mononucleosis can present with exudative pharyngitis and systemic symptoms like fatigue and lymphadenopathy, but it lacks the focal peritonsillar abscess signs. Pharyngitis is inflammation of the pharynx without the localized, pus-filled pocket and the accompanying uvular deviation and muffled voice.

Because this is an emergency, management centers on securing the airway if needed, adequate analgesia and hydration, IV antibiotics covering oral flora and anaerobes, and drainage of the abscess via needle aspiration or incision and drainage by urgency.