Bilateral peritonsillar abscess diagnosed on the basis of intraoral sonography

A peritonsillar abscess consists of suppuration outside the tonsillar capsule as a consequence of acute tonsillitis. Even though acute tonsillitis is a bilateral process, a peritonsillar abscess rarely occurs bilaterally. However, when it occurs bilaterally, the key clinical features of the peritonsillar abscess are absent. Specifically, uvular and palatal deviation away from the abscess will not be present. This can make the clinical diagnosis of a bilateral peritonsillar abscess difficult, leading to complications that include extension to the retropharyngeal space, rupture leading to aspiration, mediastinitis, erosion into the carotid artery, and sepsis. In the following case, intraoral sonography was used to show a bilateral peritonsillar abscess and to aid in its drainage. To our knowledge, this is the first case report describing a bilateral peritonsillar abscess shown by intraoral sonography.