# Bilateral Peritonsillar Abscess Secondary to Infectious Mononucleosis

## TL;DR

A 23-year-old man with infectious mononucleosis developed a rare complication of bilateral peritonsillar abscesses, requiring surgical drainage and antibiotic treatment.

## Contribution

This case report highlights the rare occurrence of bilateral peritonsillar abscesses as a complication of infectious mononucleosis.

## Key findings

- Bilateral peritonsillar abscesses can occur as a rare complication of infectious mononucleosis.
- Surgical drainage and antibiotics effectively treated the abscesses in this case.
- Physical examination is sufficient to suspect bilateral PTA, even without CT imaging.

## Abstract

Infectious mononucleosis (IM) is a clinical entity caused by Epstein-Barr infection. Serious complications during the acute phase of the infection are rare, and very few cases with bilateral peritonsillar abscesses (PTAs) have been reported to date. A 23-year-old man presented to our emergency department with fever, dysphagia, and trismus that were unresponsive to prescribed antibiotics. Physical examination revealed a bilateral PTA. The patient was admitted to the otolaryngology department, where surgical drainage of both abscesses was performed by incision. The diagnosis of bilateral PTA can be challenging because it lacks the typical clinical manifestations of unilateral PTA. Although CT imaging is frequently performed, it is not essential for diagnosis, as physical examination alone should raise suspicion, particularly in primary care settings. The combination of surgical drainage, appropriate antibiotic therapy, and close follow-up is the cornerstone of treatment. This case highlights that even common infections like IM can give rise to rare and potentially serious complications, underscoring the importance of maintaining a high index of suspicion to ensure timely diagnosis and management.