Occult peritonsillar abscess: An unusual cause of unilateral tonsillar enlargement: An unusual cause of unilateral tonsillar enlargement

Peritonsillar abscess is a suppurative infection of the tissues adjacent to the palatine tonsil and is regarded in otolarygologic practice as a complication of pharyngotonsillitis. The most common presentation is gradually increasing pain, fever, trismus, drooling and a muffled voice. Asymmetric tonsils are common in clinical practice. Differential diagnosis includes infectious, granulomatous, congenital and neoplastic lesions. This is a case study of two patients evaluated for unilateral tonsillar enlargement who were found to have a previously unexpected peritonsillar abscess at tonsillectomy. The patients had no other signs or symptoms of acute pharyngotonsillar or peritonsillar infection. To our knowledge, this is the first report of an occult peritonsillar infection causing unilateral tonsillar enlargement.