A 25-year-old female presents to an urgent care facility with a worsening sore throat over the past 4 days. She describes her voice as muffled, and she experiences significant difficulty swallowing, even liquids, leading to reduced oral intake. She reports associated headaches and general malaise. Her medical history is otherwise unremarkable, and she denies any recent sick contacts. On examination, her temperature is 39.40C, blood pressure is 122/80 mmHg, pulse is 110/min, and respirations are 20/min. Physical examination of the oropharynx reveals marked unilateral tonsillar swelling with significant deviation of the uvula to the contralateral side. There is also tenderness and swelling in the cervical region, with palpable lymphadenopathy. A CT scan of the head and neck with contrast was performed, demonstrating a well-defined, ring-enhancing fluid collection measuring 2.5 cm in diameter, located posterior and lateral to the right palatine tonsil, consistent with a peritonsillar fluid collection. Laboratory results show a white blood cell count of 18.5 x 10^9/L. Given these clinical findings and imaging results, what is the most likely diagnosis and the critical initial management step?

A 32-year-old woman presents to an urgent care facility with a 5-day history of escalating sore throat, persistent fever, and profound dysphagia affecting both solids and liquids. She reports a muffled voice and has had several episodes of spitting up small amounts of dark, clotted blood, which she initially attributed to irritation. Her symptoms have worsened significantly in the past 12 hours, now including trismus and extreme discomfort upon attempting to open her mouth fully. She denies recent dental procedures or trauma. On arrival, her temperature is 39.1°C, blood pressure is 150/100 mmHg, pulse is 110/min, respirations are 20/min, and oxygen saturation is 96% on room air. Physical examination reveals an anxious patient in mild distress. There is significant unilateral swelling of the soft palate and peritonsillar area, with the uvula deviated contralaterally. Palpation of the anterior cervical chain elicits exquisite tenderness and firm, enlarged lymph nodes. Oral examination is limited by trismus, but a small trickle of fresh, bright red blood is noted from the affected tonsillar area. The patient speaks in short, gasped sentences due to pain and difficulty breathing. What is the most probable diagnosis and the immediate critical management step?

A 25-year-old female presents to an outpatient clinic with a worsening sore throat that began insidiously over the past week and has become significantly more severe in the last 72 hours. She reports a progressive difficulty swallowing, especially for solids and even her own saliva, and a muffled, gargled quality to her voice, often described as a “hot potato” voice. She also notes a persistent high-grade fever and increasing difficulty opening her mouth fully. Her past medical history is unremarkable, and she denies any recent travel or exposure to sick contacts. On examination, her temperature is 39.50C, pulse 110/min, blood pressure 110/70 mmHg, and respiratory rate 20/min. She appears acutely distressed, frequently clearing her throat, and has noticeable drooling. Oral examination reveals significant unilateral swelling and erythema of the right tonsil, with the uvula markedly displaced to the left, almost touching the contralateral tonsil. Palpation of the right anterior cervical triangle elicits marked tenderness and reveals enlarged, firm lymph nodes. Given these findings, what is the most likely diagnosis and the appropriate initial management strategy?