Dysphagia in a 1,5 year old child

Peritonsillar abscesses usually occur primarily in young adults. In children, they play a minor role. Etiologically, peritonsillar abscesses are polymicrobial infections mostly caused by group A streptococcus and anaerobic bacteria. In recurrent acute tonsillitis, an abscess-formation in the lymphatic tissue (especially in the upper pole of the tonsil) may occur. Symptoms range from sore throat, dysphagia, trismus, voice disorders (“hot potato voice”), low general condition through acute dyspnea. Therapy includes abscess drainage, calculated intravenous antibiotic therapy, hydration, and pain medication to avoid serious complications.

Case Report A 1,5-year-old girl was presented with high fever, dysphagia, swollen lymphatic glands, and insufficient drinking. Otolaryngological examination showed an erythematous and edematous superior arch of the soft palate on the left side. The laboratory values presented a high CRP (20,1 mg/dl) and high leucocytes. The diagnosis was confirmed via ultrasound of the head and neck and an abscess tonsillectomy on the left side in general anesthesia was performed. Intraoperatively, a feather was found in the abscess cavity and was the probable cause of the peritonsillar abscess.

Conclusion Peritonsillar abscesses are rare in children under the age of six years. The therapy in children includes abscess drainage and intravenous application of antibiotics. Causes for a peritonsillar abscess in very young children could also be untypically like sharp foreign bodies that cause an infection in the lymphatic tissue.

Publication History

Article published online:
27 June 2023