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Inicio Acta Otorrinolaringológica Española Intratonsillar Abscess, a Rare Cause of Odynophagia
Journal Information
Vol. 68. Issue 4.
Pages 246-247 (July - August 2017)
Vol. 68. Issue 4.
Pages 246-247 (July - August 2017)
Images in Otorhinolaryngology
DOI: 10.1016/j.otoeng.2017.06.002
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Intratonsillar Abscess, a Rare Cause of Odynophagia
Absceso intratonsilar, rara causa de odinofagia
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Blidy N. Añaguari
Corresponding author
noemithhass@gmail.com

Corresponding author.
, Juan Rebollo, Cristina Montes
Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario de Puerto Real, Puerto Real, Cádiz, Spain
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A 50-year-old female patient, with a two-week history of moderate odynophagia and general malaise, with no trismus, treated with antibiotic therapy, with no improvement. On examination she presented an enlarged right palatine tonsil and erythema, no swelling of the pillars or pharyngeal walls. Since the odynophagia persisted a cervical MRI scan was requested. Fig. 1 is a T2 axial sequence with fat suppression. A rounded lesion can be seen deep in the right tonsil, presenting a hypointense capsule (long arrow) and a hyperintense central area (short arrow) corresponding to a fluid/necrotic formation and local hyperintensity of the adjacent tissues suggestive of peritonsillar and parapharyngeal inflammatory changes. Figs. 2 and 3 are coronal and axial T1 sequences, with fat suppression and contrast. The uptake is shown here of the lesion capsule (long arrow) and decreased uptake at the centre which shows necrosis of the abscess (short arrow).

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A tonsillar puncture was performed, and purulent material obtained without remission, therefore the patient underwent a bilateral tonsillectomy with favourable outcome.

Intratonsillar abscesses are rare; their prevalence is underestimated, there being only 20 reported cases. They form as sequelae of acute follicular tonsillitis. Obstruction of the crypt is the fundamental mechanism for formation of these abscesses. The most commonly described symptoms are odynophagia, trismus and fever. Contrast CAT/MRI scans are useful for diagnosis. Treatment is with antibiotics, drainage or tonsillectomy.

Please cite this article as: Añaguari BN, Rebollo J, Montes C. Absceso intratonsilar, rara causa de odinofagia. Acta Otorrinolaringol Esp. 2017;68:246–247.

Copyright © 2016. Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello
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