Pediatric emergency medicine trisk 1473 1473

Stomatitis caused by herpes simplex virus is usually confined to the anterior buccal mucosa but occasionally may extend to the anterior tonsillar pillars and involve the upper esophagus in immunocompetent patients on rare occasions ( e-Fig 74.1 ) Particularly in more extensive cases, the child may complain of a sore throat Peritonsillar Abscess A peritonsillar abscess may complicate a previously diagnosed infectious pharyngitis or may be the initial source of a child’s discomfort This occurs most commonly in older children and adolescents Trismus is common in these patients The diagnosis is evident from visual inspection, augmented occasionally by careful palpation These abscesses produce a bulge in the posterior aspect of the soft palate, deviate the uvula to the contralateral side of the pharynx, and have a fluctuant quality on palpation ( e-Fig 74.2 )