Necrotizing herpes-simplex virus tonsillitis mimicking peritonsillar abscess

Excerpt

A 63-year-old neutropenic woman under treatment with cytarabin and idarubicin for acute myeloid leukemia complained of left-sided throat pain and increasing difficulties in swallowing. She was already receiving cefepime and metronidazole for neutropenic fever. Physical examination revealed a febrile patient with an enlarged fibrinous coated medially displaced left tonsil in the absence of oral blisters. A computed tomography demonstrated a peritonsillar abscess formation (Fig. 1a). Needle aspiration of the peritonsillar collection was unsuccessful making a tonsillectomy mandatory. The tonsil appeared brittle and disaggregated in several pieces while performing tonsillectomy. No purulent discharge was seen during the procedure.

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