Differential Diagnosis

The patient's symptoms of keeping their head tilted to the left side, trouble swallowing, drooling, fever, and severe swelling of the left peritonsillar area suggest a serious infection or condition affecting the throat. Here's a categorized differential diagnosis:

• Single most likely diagnosis

  • Peritonsillar abscess: This condition is characterized by a collection of pus behind the tonsils, which can cause severe pain, swelling, difficulty swallowing, and fever. The patient's symptoms, including the severe swelling of the left peritonsillar area, strongly suggest this diagnosis.

• Other Likely diagnoses

  • Tonsillitis: Inflammation of the tonsils can cause pain, fever, and difficulty swallowing. While it's less likely given the severe swelling, it's a possible diagnosis if the swelling is due to inflammation rather than an abscess.
  • Retropharyngeal abscess: Although less common, this condition involves an abscess in the tissues in the back of the throat, which can cause similar symptoms, including difficulty swallowing and fever.

• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)

  • Epiglottitis: This is a potentially life-threatening condition that involves inflammation of the epiglottis, which can cause severe difficulty swallowing, drooling, and fever. It requires immediate medical attention.
  • Ludwig's angina: A severe infection of the tissues in the neck, which can cause swelling, difficulty swallowing, and fever. It's a medical emergency due to the risk of airway obstruction.

• Rare diagnoses

  • Lemierre's syndrome: A rare condition characterized by a bacterial infection of the jugular vein, which can follow a throat infection. It's less likely but should be considered in cases of severe throat infection with systemic symptoms.
  • Deep neck infections (e.g., parapharyngeal abscess): These are infections in the spaces of the neck and can cause similar symptoms, including difficulty swallowing and fever. They are less common but require prompt treatment to prevent complications.