Bilateral Peritonsillar Abscess in a Secondary Health Facility in North-Western Nigeria: A Case Series of Two Patients

Lawal Shu’aibu¹, Abdullahi Adamu², Sani Dandela²

Keywords: Peritonsillar abscess, quinsy tonsillectomy, abscess aspiration, trismus

DOI: 10.63475/yjm.v5i1.0308

DOI URL: https://doi.org/10.63475/yjm.v5i1.0308

Publish Date: 17-04-2026

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Author Affiliation:

1 Consultant, Ear, Nose, and Throat, Head and Neck Surgeon, Department of Ear, Nose, and Throat, Federal Teaching Hospital Katsina, Katsina, Nigeria
2 Senior Registrar, Department of Ear, Nose, and Throat, Federal Teaching Hospital Katsina, Katsina, Nigeria

Abstract

A peritonsillar abscess (PTA) is a localized collection of pus in the space between the tonsillar capsule and the superior constrictor muscle. It is the most common infection of the deep neck spaces. Bilateral PTA (BPTA) is rare and may mimic the symptoms of acute tonsillitis, often leading to delayed diagnosis. Treatment options include needle aspiration, incision and drainage, and quinsy tonsillectomy. The first case involved a 16-year-old girl who presented with a 1-week history of progressively worsening sore throat, odynophagia, persistent fever, and bilateral earache but no respiratory difficulty. On examination, she was in painful distress, dehydrated, febrile, and not pale. She had bilateral tender jugulodigastric lymphadenopathy, mild trismus, enlarged hyperemic kissing tonsils, inflamed peritonsillar regions, and a centrally positioned but edematous uvula. Bilateral needle aspiration yielded pus, and she responds well to antibiotics and supportive treatment. The second case was a 13-year-old boy who presented with an 8-day history of progressive throat pain, dysphagia, fever, bilateral referred otalgia, difficulty in mouth opening, and a change in voice, but no respiratory distress. He appeared in painful distress, febrile, dehydrated, with a “hot potato” voice and moderate to severe trismus. Attempts to further examine the oropharynx and aspirate the pus were not successful due to severe trismus. He underwent a quinsy tonsillectomy and responded well to broad-spectrum antibiotics. In conclusion, BPTA is uncommon and requires a high index of suspicion for prompt diagnosis and timely management to prevent life-threatening complications.

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