With your treatment, the patient improves significantly and begins eating and drinking. As such he is discharged home.

 

Three days later the patient represents to A&E with the pain now more unilateral on the left-side of the throat. His voice has now changed and the last 24 hours he has noticed that mouth opening has become difficult.

 

On examination his observations are:

Blood pressure of 135/90

Pulse 101bpm regular 

Sats 100% on air

Respiratory rate of 22.

 

The oropharynx is difficult to visualise due to a 1.5cm trismus. However, the left tonsil is very large and the soft palate appears to be bulging on that side. The uvula deviates to the right.