A Lot to Choke on: Case of Adult Epiglottitis with Concurrent Peritonsillar Abscess in a Patient with a Sore Throat

Abstract

Background: In the winter months, one often sees a large increase in the volume of patients presenting to emergency departments with acute pharyngitis. While most cases of acute pharyngitis are benign, a rare minority can be life threatening.

Case report: We report a case of epiglottis with a concomitant peritonsillar abscess (PTA) in an adult who presented to the emergency department with a sore throat. Computed tomography (CT) scan showed epiglottitis with a developing left PTA. The patient was treated with broad-spectrum antibiotics, high-dose steroids, and underwent multiple laryngoscopies with eventual resolution of his epiglottic swelling. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case serves to highlight the importance of physical examination and CT imaging in identifying patients with pharyngitis who can benefit from additional interventions and monitoring. It is also an unusual example of the presence of two likely related upper respiratory pathologies presenting in the same patient.

Keywords: ENT; PTA; airway; deep-space neck infection; drooling; dysphagia; epiglottitis; odynophagia; peritonsillar abscess; pharyngitis; sore throat; stridor; throat; throat pain; tonsillar abscess.