Which finding is a hallmark of a peritonsillar abscess?

• A. Fever with productive cough
• B. Dysphagia and sore throat only
• C. Muffled voice, uvula deviation, and pooling of saliva
• D. Ear pain without throat symptoms

Answer: (C)

Peritonsillar abscess creates swelling and pus in the tonsillar area that shifts surrounding structures. The resulting muffled voice, the uvula deviating away from the affected side, and pooling of saliva due to painful swallowing are the classic signs you’d expect. The muffled or “hot potato” voice comes from the mass effect and altered resonance; the uvula is pushed to the opposite side by the swollen tissue; and saliva pools because swallowing is painful and difficult. This combination is much more specific for this condition than fever with a productive cough (suggesting a lower respiratory infection), dysphagia and sore throat alone (which can occur with many throat issues but lacks the distinctive voice and uvular changes), or ear pain without throat symptoms.