GP CCE Cases · ear-nose-throat-and-oral-health
Sore throat with unilateral worsening — CCE clinical encounter
CCE-style clinical encounter: a 22-year-old student five days into tonsillitis returns with severe left-sided pain, muffled voice and trismus. The candidate must recognise quinsy, arrange drainage, and counsel on the original no-antibiotic decision.
On this page
Study tools
Target exams
RACGP CCEFRACGP oralsCFPC SOOs
Prompt
A 22-year-old university student returns five days after being managed without antibiotics for a viral sore throat (FeverPAIN 1). She has severe left-sided throat pain, can barely open her mouth, speaks in a muffled 'hot potato' voice, is drooling slightly, and looks unwell. Temperature 38.7°C. The left tonsil is swollen medially pushing the uvula to the right.
Objectives
- Recognise peritonsillar abscess (quinsy) clinically — unilateral pain, trismus, muffled voice, uvular deviation. [5]
- Arrange urgent drainage plus antibiotics rather than oral therapy alone. [5]
- Revisit the original no-antibiotic decision honestly with the patient. [1]
- Safety-net for airway compromise and set the post-drainage plan. [5]
References2ShowHide
- [1]Spinks A, Glasziou PP, Del Mar CB Antibiotics for treatment of sore throat in children and adults. Cochrane Database of Systematic Reviews, 2021.PMID 34881426
- [5]Stelter K Tonsillitis and sore throat in children. GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery, 2014.PMID 25587367