Differential Diagnosis for Unilateral Tonsil Swelling
- Single Most Likely Diagnosis
- Peritonsillar abscess: This is the most common cause of unilateral tonsil swelling, typically presenting with severe throat pain, fever, and difficulty swallowing. The abscess forms beside the tonsils, causing swelling and pushing the tonsil towards the midline.
- Other Likely Diagnoses
- Tonsillitis: Inflammation of the tonsils, which can be viral or bacterial, often presents with bilateral swelling but can be unilateral. Symptoms include sore throat, fever, and white patches on the tonsils.
- Tonsil stone (Tonsillolith): A stone that forms on the surface of the tonsil, which can cause localized swelling, bad breath, and a feeling of something being stuck in the throat.
- Mononucleosis (infectious mononucleosis): Caused by the Epstein-Barr virus, it can lead to unilateral or bilateral tonsillar enlargement, along with fever, sore throat, and lymphadenopathy.
- Do Not Miss Diagnoses
- Malignancy (e.g., squamous cell carcinoma): Although rare, cancer of the tonsil can present with unilateral swelling, pain, and difficulty swallowing. Early detection is crucial for effective treatment.
- Lemierre's syndrome: A rare but serious condition that starts with a sore throat and progresses to a bacterial infection of the jugular vein, leading to sepsis. It's characterized by high fever, neck pain, and swelling.
- Rare Diagnoses
- Kikuchi-Fujimoto disease: A rare, self-limiting condition that causes lymphadenopathy, often accompanied by unilateral tonsillar swelling, fever, and night sweats.
- Actinomycosis: A chronic bacterial infection that can cause abscesses and masses in the neck, including the tonsillar area, often presenting with swelling, pain, and difficulty swallowing.
- Sarcoidosis: A systemic disease that can affect any organ, including the lymph nodes in the neck, potentially causing unilateral tonsil swelling, though this is a rare presentation.