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If the child is uncooperative a general anaesthetic may be required. Some small foreign bodies can often be removed by syringing but removal of vegetable matter by syringing is contraindicated because of the danger of the material absorbing water and swelling. Figures 121 and 122 If the object is superficial it may be possible to grasp it with crocodile forceps or extract it with a wax hook. Using a head mirror for illumination, the foreign body can be gently grasped and extracted easily. Figure 122 60 Figure 123 Small objects can often be removed by syringing but larger foreign bodies such as this section of an eraser which virtually fills the lumen may be pushed further in by syringing or attempts at extraction.

Figure 75 40 Figure 76 Unilateral tonsillar enlargement when accompanied by great tenderness and trismus is suggestive of quinsy, as in this case. It resolved with intramuscular penicillin without admission or tonsillectomy. A four year follow-up showed no recurrence. " Throat culture stands as the definitive answer, but it is a very specific test with a small proportion of false negatives and an even smaller proportion of false positives. Its drawbacks are obvious: delay and expense and at least three out of four negative cultures if all throats are swabbed.

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Boo Boo and the V.I.V.

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