Back to Basics: Peritonsillar Abscess

Clinical Presentation:

  • Sore Throat
  • Voice Change
  • Uvula deviation away from the abscess
  • Fever/Chills
  • Ipsilateral Ear pain/torticollis

Next Step:

Intra-Cavitary probe U/S:

  • Evaluate efficacy of I&D
  • Depth of abscess to measure needle guard
  • Identify location of carotid artery relative to the abscess



  • Nebulized lidocaine/Regional lidocaine injection for analgesia
  • Use the needle guard
  • Make small adjustments with the needle medially to avoid the carotid

Antibiotics (Polymicrobial Infections):

  • IV: ampicillin/sulbactam or clindamycin
  • Outpatient: Penicillin, clindamycin, and Amoxicillin/clavulanate


  • Single high-dose administration has been shown to provide symptomatic relief


Mapelli E, Sabhaney V. "Stridor and Drooling in Infants and Children."Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8eEds. Judith E. Tintinalli, et al. New York, NY: McGraw-Hill, 2016, pg 800-801.