# Acute Intratonsillar Abscess in an Adult: A Case Report and Literature Review

## TL;DR

This case report describes a rare adult case of acute intratonsillar abscess and reviews treatment approaches from the literature.

## Contribution

The paper presents a rare adult case of ITA and proposes updated treatment guidelines based on case data and literature review.

## Key findings

- Computed tomography and clinical findings were used to diagnose the intratonsillar abscess.
- IV clindamycin and dexamethasone, along with drainage, were effective in treating the case.
- Literature analysis suggests IV antibiotics with aspiration as primary treatment for acute ITA.

## Abstract

Intratonsillar abscess (ITA) is rarely reported. Here, we present an uncommon case of acute ITA in an adult, discuss the evaluation and treatment plan, and review the ITA literature.

The abscess reported in the present study was diagnosed through a combination of clinical findings and computed tomography imaging, and treatment included drainage, intravenous (IV) clindamycin, and IV dexamethasone.

The literature reports 72 ITA cases with specified treatments: 21 (29.2%) in adults, 19 (26.4%) in children, and 32 (44.4%) in patients of unspecified ages. Among them, 25 (34.7%) responded to antibiotics alone, 11 (15.3%) to needle aspiration and antibiotics, and 36 (50.0%) needed further intervention.

Based on the presented case and literature review, we suggest the use of IV antibiotics with needle aspiration as the primary treatment for acute ITA. Incision and drainage (I&D) with antibiotics should be reserved for cases unresponsive to initial measures, and tonsillectomy is recommended for recurrent post-I&D cases.