WIDI - CA0122-Tonsillar Abscess, CT

Tonsillar Abscess, CT

Claim CME Credit

0.5 CME Credit available on completion

POINT OF CARE INFORMATION

This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.

Learning Objectives

As a result of participation in this activity, participants should be able to:

Provide improved patient care.
Greater knowledge of the imaging characteristics of the patient's disease.
Understand a better approach to interpretation of studies.

Faculty Disclosure

Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.

CME Advisory Committee Disclosure:

Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.

Continuing Medical Education Credit

Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CA0122-Tonsillar Abscess, CT

History

27-year old female in the emergency room with fever, throat pain and possible aggressive pharyngitis, tonsillar or peritonsillar, infection.

Exam

Contrast-enhanced CT of the maxillofacial region and neck and related anatomy with images obtained in the balanced or venous vascular phase to ensure optimal visualization of both arterial and venous structures as well as possible reactive changes around infected collections. 0.5-3.0 mm thick sections were obtained in the axial plane and reformatted 3D and/or in the coronal and sagittal planes and viewed inter actively in 3 dimensions at the computer work station.

Findings

Nasopharynx Including Retropharyngeal Lymph Nodes

There is normal hypertrophy of the lymphoid tissue in the nasopharynx, somewhat more pronounced on the right side. There is minimal edema within the fat of the adjacent parapharyngeal space on the right.

Oropharynx

There is excessive enhancement and hypertrophy of the palatine tonsillar tissue and less pronounced within the lingual tonsillar and the lymphoid tissue along the glossotonsillar sulci consistent with generalized pharyngitis.

There is an abscess relatively centrally within the lymphoid tissue of the left palatine tonsil. There is no evidence of peritonsillar abscess. There is minimal related cellulitis in adjacent parapharyngeal space on the left.

Retropharyngeal and Cervical Lymph Nodes

There are some prominent lymph nodes in level 2 and 3 bilaterally and in the retropharyngeal space on the left.

Vascular Findings

There is no evidence of thrombus, thrombophlebitis or other occlusive or inflammatory process of the jugular vein or smaller venous tributaries.

Impression

Pharyngitis and tonsillitis, complicated by a tonsillar abscess on the left.

Recommendations

The emergency medical service team was notified verbally that there was a tonsillar abscess present and they consulted the otolaryngology service at that time to help with further management.

Acuity

Urgent: non-routine communication within 4 hours