Differential Diagnosis for Severe Sore Throat and Peritonsillar Swelling
Single Most Likely Diagnosis
- Peritonsillar Abscess: This condition is highly suggested by the severe sore throat, pain with swallowing, occasional drooling, and significant swelling of the peritonsillar area. The exposure to streptococcus further supports this diagnosis, as streptococcal infections are a common cause of peritonsillar abscesses.
Other Likely Diagnoses
- Tonsillitis: Given the exposure to streptococcus and symptoms of severe sore throat and swelling, tonsillitis is a plausible diagnosis. However, the specific mention of peritonsillar swelling and drooling leans more towards a peritonsillar abscess.
- Ludwig's Angina: Although less common, Ludwig's angina is a consideration with severe neck swelling and pain with swallowing. It typically involves the submandibular space, which might not be directly implied here but remains a possibility with severe infections in the head and neck area.
Do Not Miss Diagnoses
- Epiglottitis: This is a potentially life-threatening condition that requires immediate attention. Symptoms can include severe sore throat, difficulty swallowing, and drooling. Although the primary symptom of peritonsillar swelling does not directly point to epiglottitis, the severity of symptoms and potential for airway compromise make it a critical diagnosis not to miss.
- Retropharyngeal Abscess: Another serious condition, especially in children but also in adults, that can present with neck stiffness, severe sore throat, and difficulty swallowing. It's crucial to consider this diagnosis due to its potential for airway obstruction and other complications.
Rare Diagnoses
- Lemierre's Syndrome: A rare condition characterized by a sore throat followed by neck pain and swelling due to a jugular vein thrombosis, typically resulting from a fusobacterial infection. It's less likely given the direct exposure to streptococcus and the specific symptoms described but remains a rare possibility.
- Tuberculous Tonsillitis: Although rare in many parts of the world, tuberculous infection of the tonsils can present with chronic sore throat and swelling. The acute presentation and exposure to streptococcus make this less likely, but it should be considered in endemic areas or in patients with risk factors for tuberculosis.