Background: Acute tonsillitis is an extremely common infection seen in children and adults. In most cases, the family doctor is initially consulted. Intratonsillar, peritonsillar and retrotonsillar abscesses are frequent complications in the course of tonsillitis. In those cases, oropharyngeal infection may lead to a descending process with consecutive mediastinitis as a life-threatening condition.
Patients and methods: We report the case of a 67-year old man who died of a mediastinitis resulting from a peritonsillar abscess. Clinical findings, radiological diagnostics and antibiotic as well as surgical therapy are illustrated.
Results: The patient died due to a septic multi-organic failure despite aggressive antibiotic and surgical therapy by a combined enoral and cervical approach with thoracic drainage.
Discussion: Peritonsillar abscess is a potentially life-threatening complication of acute tonsillitis. This must be kept in mind and should therefore lead to an adequate and directed management of this pathology. We discuss the stepwise diagnosis and therapy within the framework of scientific literature.