Figure 1. Tonsils showing shallow ulcers (arrows) secondary to coxsakievirus.
Figure 2. Enlarged tonsils R>L secondary to infectious mononucleosis.
An 18 year old woman complained of gradual onset throat pain and symptoms of a viral URI with nasal congestion, conjunctivitis and coryza. Later, faint macular rash appeared on her hands. Shallow ulcers developed on her tonsils (Figure 1). She was diagnosed with coxsakie viral infection and treated conservatively with ibuprofen.
A 19 year old man was seen for fatigue, malaise and odynophagia. Because of concern for peritonsilar abscess due to R>L tonsil enlargement (Figure 2) he was given intravenous steroids and antibiotics. His pain improved dramatically and he tested positive for infectious mononucleosis.
Adam M. Knox and Alexander G. Chiu, MD
Department of Otolaryngology
University of Arizona, Tucson
Reference as: Knox AM, Chiu AG. Medical image of the week: teenage tonsils. Southwest J Pulm Crit Care. 2015;11(1):51-2. doi: http://dx.doi.org/10.13175/swjpcc071-15 PDF