Uvular Edema as a Red Herring: An Atypical Presentation of Peritonsillar Abscess without Classic Tonsillar Bulge or Trismus

Ahmed LA*, Hasan Y and Tamer Eldesoky
 

Head of ENT Department, Buraidah Central Hospital, Buraidah, Saudi Arabia
ENT Consultant, Buraidah Central Hospital, Buraidah, Saudi Arabia
ENT Senior Specialist, Buraidah Central Hospital, Buraidah, Saudi Arabia

^*Correspondance to: Latifi Asrar Ahmed  

 PDF  Full Text DOI: 10.25107/2474-1647.3741

Abstract

Peritonsillar Abscess (PTA) classically presents with severe unilateral odynophagia, trismus, muffled voice, and medial tonsillar displacement with contralateral uvular deviation. We report a 56-year-old male smoker with hypertension who presented with four days of progressive throat pain and dysphagia dominated by marked cystic enlargement of the uvula and bilateral tonsillar enlargement, without significant anterior-pillar bulge, trismus, fever, or airway compromise. Initial conservative therapy with corticosteroids and antibiotics produced partial resolution of uvular edema but persistent dysphagia. Contrast-enhanced CT of the neck revealed a 15 mm right peritonsillar collection with mild peripheral rim enhancement and moderate upper-airway narrowing. Needle aspiration yielded 2 mL of pus; culture grew Streptococcus species sensitive to ceftriaxone and clindamycin. Addition of clindamycin led to rapid clinical and laboratory improvement. This case highlights that PTA can masquerade as isolated uvular edema (Quincke’s disease) and underscores the value of early cross-sectional imaging when classic local signs are incomplete or absent.

Keywords

Keywords: Peritonsillar abscess; Uvular edema; Quincke’s disease; Atypical presentation; Needle aspiration

Cite the article

Ahmed LA, Hasan Y, Tamer Eldesoky. Uvular Edema as a Red Herring: An Atypical Presentation of Peritonsillar Abscess without Classic Tonsillar Bulge or Trismus. Clin Surg. 2026; 10: 3741.