Uncommon extension of peritonsillar abscess

Peritonsillar abscess refers to the collection of pus in between the tonsillar capsule and the superior constrictor muscle. The majority of patients with peritonsillar abscess recover uneventfully after intraoral drainage and antibiotic therapy. However, some patients who are immunosuppressed might deteriorate as infection spreads into the deep neck spaces or upper airway mucosa. We report a case of 48-year-old immunocompetent patient with peritonsillar abscess extending primarily into the parapharyngeal and retropharyngeal spaces, followed by unusual secondary extension into the masticator space, the submandibular region, and the anterior neck region. Both intraoral and extraoral incisions were conducted. The patient fully recovered after the drainage procedure and antibiotic treatment.