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Unexpected quinsy

Sir, we would like to report the case of an 11-year-old male, who presented to an emergency dental service with a three day history of pain from the lower right quadrant and difficulty in swallowing. Coincidentally, antibiotics had been prescribed by his general medical practitioner, three days prior to this, for an unrelated ear infection. The patient had an unremarkable medical history. At the EDS, upon clinical examination, the patient appeared systemically unwell and bilateral lymphadenopathy of the submandibular and submental triangles was palpated. Intraoral examination did not reveal any obvious or related dental pathology, however, a right soft palate and fauceal swelling, with uvular displacement, was noted. A provisional diagnosis of a quinsy was made; therefore, the patient was referred to the local paediatric ENT service and the diagnosis was confirmed. He was admitted, rehydrated, given intravenous antibiotics and the abscess was drained successfully.

This case highlights that there can be unexpected findings in a patient who attends with what appears to be a dental related problem. It also emphasises the need for a high index of suspicion for other types of pathology when carrying out a dental examination.

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Bussell, M., Heady, J. Unexpected quinsy. Br Dent J 203, 227–228 (2007). https://doi.org/10.1038/bdj.2007.797

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