A 29 y/o graduate student presents with a 4 day history of fever, chills, sore throat and dysphagia. She denies sick contacts or multiple sexual partners. Her BP is 116/76, pulse 104, respirations 18, temperature 39.8C (102.2F). On exam, her voice is muffled. Pooling of saliva and trismus is noted. She has cervical lymphadenopathy and a deviated uvula.
This is a condition known as peritonsillar abscess, or quinsy,, often a complication of acute tonsillitis. Occurs in patients 15-30 with all the aforementioned symptoms. Treatment consists of needle drainage in the Trendelenburg position, close monitoring and IV antibiotics.