What causes a peritonsillar abscess. How is a peritonsillar abscess diagnosed. What are the symptoms of a peritonsillar abscess. How is a peritonsillar abscess treated. Can peritonsillar abscesses be prevented.

What is a Peritonsillar Abscess?

A peritonsillar abscess is a serious medical condition characterized by the accumulation of pus-filled tissue at the back of the mouth, adjacent to one of the tonsils. This condition can be extremely painful and may cause significant discomfort, making it difficult for the affected individual to open their mouth or swallow normally.

The abscess can lead to swelling that pushes the tonsil towards the uvula, potentially obstructing the throat and causing difficulties in swallowing, speaking, and in severe cases, even breathing. Due to its potential complications, immediate medical attention is crucial if you suspect you have developed a peritonsillar abscess.

Causes and Risk Factors of Peritonsillar Abscesses

The primary cause of peritonsillar abscesses is bacterial infection. In most cases, the bacteria responsible for strep throat are the culprits behind these abscesses. However, other types of bacteria can also be involved in some instances.

Peritonsillar abscesses often develop as a complication of tonsillitis. When the infection breaks out of a tonsil and spreads to the surrounding area, an abscess can form. It’s worth noting that the incidence of peritonsillar abscesses has decreased in recent years due to the widespread use of antibiotics in treating tonsillitis.

Several risk factors can increase an individual’s likelihood of developing a peritonsillar abscess:

• Gum disease
• Smoking
• Recurring tonsillitis
• Poor oral hygiene
• Weakened immune system

Recognizing the Symptoms of a Peritonsillar Abscess

Identifying the symptoms of a peritonsillar abscess is crucial for early diagnosis and treatment. The initial sign is often a sore throat, which may be mistaken for a common cold or strep throat. As the abscess develops, additional symptoms may emerge:

• Red, swollen tonsils
• Tender, swollen lymph nodes on one side of the neck
• Severe pain localized to one side of the throat
• Difficulty and pain when swallowing or opening the mouth
• Fever and chills
• Headache
• Earache
• Drooling
• Muffled or hoarse voice
• Bad breath

If left untreated, a peritonsillar abscess can lead to serious complications. The infection may spread to the jaw and neck, and if the abscess ruptures, it could potentially lead to pneumonia if the infection reaches the chest cavity.

Diagnostic Procedures for Peritonsillar Abscesses

Prompt diagnosis of a peritonsillar abscess is essential for effective treatment. If you experience a sore throat accompanied by fever or any of the aforementioned symptoms, it’s crucial to seek medical attention immediately.

During the diagnostic process, your healthcare provider will typically:

1. Perform a thorough examination of your mouth, throat, and neck
2. Look for an extremely swollen, red area around the tonsil that may be pushing against the uvula
3. Possibly take a throat culture and blood test
4. In rare cases, order a CT scan or ultrasound for a more detailed view

In severe cases where the abscess is affecting your ability to breathe, immediate emergency care may be necessary.

Treatment Options for Peritonsillar Abscesses

The primary goal in treating a peritonsillar abscess is to drain the accumulated pus and eliminate the infection. Treatment options may include:

1. Drainage Procedures

The most common treatment involves draining the abscess. This can be done through two methods:

• Aspiration: The doctor withdraws the pus using a needle
• Incision and drainage: A small cut is made in the abscess to allow the pus to drain out

2. Tonsillectomy

In cases where drainage procedures are ineffective or for individuals with a history of recurrent tonsillitis or peritonsillar abscesses, a tonsillectomy (surgical removal of the tonsils) may be recommended.

3. Medication

In addition to drainage procedures, your doctor will likely prescribe:

• Antibiotics to fight the underlying infection
• Pain relievers to manage discomfort

It’s crucial to complete the entire course of antibiotics as prescribed, even if symptoms improve, to prevent the infection from recurring.

4. Supportive Care

In cases where eating or drinking is difficult, intravenous fluids may be administered to prevent dehydration. Some patients may require a brief hospital stay for monitoring, especially following a tonsillectomy.

Potential Complications of Untreated Peritonsillar Abscesses

Failing to seek prompt treatment for a peritonsillar abscess can lead to severe complications. These may include:

• Spread of infection to surrounding tissues
• Airway obstruction
• Sepsis (a life-threatening systemic infection)
• Necrotizing fasciitis (a rare but severe soft tissue infection)
• Pneumonia (if the abscess ruptures and the infection spreads to the lungs)

Given these potential risks, it’s crucial to seek medical attention at the first sign of symptoms associated with a peritonsillar abscess.

Prevention Strategies for Peritonsillar Abscesses

While not all cases of peritonsillar abscesses can be prevented, there are several steps you can take to reduce your risk:

1. Maintain good oral hygiene: Brush and floss regularly to reduce bacteria in your mouth
2. Avoid smoking: Smoking can irritate your throat and increase your risk of infection
3. Treat strep throat promptly: Complete the full course of antibiotics if diagnosed with strep throat
4. Boost your immune system: Eat a balanced diet, exercise regularly, and get adequate sleep
5. Stay hydrated: Drinking plenty of water can help flush out bacteria from your throat

Despite these preventive measures, sometimes peritonsillar abscesses can develop due to factors beyond your control. If you suspect you have an abscess, seek medical attention promptly. Early diagnosis and treatment can significantly improve outcomes and prevent more serious complications.

Living with and Managing Peritonsillar Abscesses

Recovering from a peritonsillar abscess can be challenging, but with proper care and follow-up, most individuals make a full recovery. Here are some tips for managing your condition during and after treatment:

• Follow your doctor’s instructions carefully, especially regarding medication
• Get plenty of rest to allow your body to heal
• Stay hydrated by drinking plenty of fluids
• Eat soft, cool foods to minimize discomfort while swallowing
• Use over-the-counter pain relievers as recommended by your doctor
• Avoid smoking and exposure to secondhand smoke
• Attend all follow-up appointments to ensure proper healing

By following these guidelines and maintaining good oral hygiene, you can support your recovery and reduce the risk of future episodes.

Understanding peritonsillar abscesses, their causes, symptoms, and treatment options is crucial for anyone at risk of developing this condition. While it can be a painful and potentially serious problem, with prompt medical attention and proper care, most cases can be successfully treated. Remember, prevention is always better than cure, so prioritize your oral health and seek medical advice at the first sign of persistent throat pain or other concerning symptoms.

Peritonsillar Abscess (for Teens) – Nemours KidsHealth

en español: Abscesos periamigdalinos

Medically reviewed by: Elana Pearl Ben-Joseph, MD

What’s a Peritonsillar Abscess?

A peritonsillar abscess is an area of pus-filled tissue at the back of the mouth, next to one of the tonsils. The abscess can be very painful and can make it hard to open the mouth.

It can also cause swelling that can push the tonsil toward the uvula (the dangling fleshy object at the back of the mouth). This can block the throat, making it hard to swallow, speak, and sometimes even breathe.

If you think you have an abscess in the back of your throat, you need to see a doctor. A peritonsillar abscess that isn’t treated can lead to more serious health problems.

What Causes Peritonsillar Abscesses?

Most peritonsillar abscesses are caused by the same bacteria that cause strep throat. Sometimes, other types of bacteria are involved.

Peritonsillar abscesses usually happen as a complication of tonsillitis. If the infection breaks out of a tonsil and gets into the space around it, an abscess can form. Luckily, peritonsillar abscesses aren’t that common these days because doctors use antibiotics to treat tonsillitis.

Gum disease and smoking can increase a person’s chances of developing an abscess.

What Are the Signs of a Peritonsillar Abscess?

Often, the first sign of a peritonsillar abscess is a sore throat. As the abscess develops, other symptoms start, such as:

• red, swollen tonsils
• tender, swollen glands (lymph nodes) on one side of the neck
• severe pain on one side of the throat
• difficulty and pain when swallowing or opening the mouth
• fever and chills
• headache
• earache
• drooling
• a muffled or hoarse voice
• bad breath

An abscess that’s not treated quickly can lead to serious problems — for example, the infection may go into the jaw and neck. If the abscess pops, the infection may spread to the chest and lead to pneumonia.

How Is a Peritonsillar Abscess Diagnosed?

Call your doctor if you have a sore throat with a fever or any of the other problems that can be caused by a peritonsillar abscess. It’s rare that an abscess will get in the way of your breathing, but if it does, you may need to go to the emergency room right away.

The doctor will examine your mouth, throat, and neck. They will look for an extremely swollen red area around the tonsil that pushes against the uvula. They also may take a throat culture and a blood test. On rare occasions, a doctor may order a CT scan or ultrasound.

How Is a Peritonsillar Abscess Treated?

The usual treatment for a peritonsillar abscess involves having a doctor drain the abscess. The doctor does this either by withdrawing the pus with a needle (called aspiration) or making a small cut in the abscess with a scalpel so the pus can drain out.

If this doesn’t work, a patient’s tonsils might have to be removed in a procedure called a tonsillectomy. This is especially true for people who have had tonsillitis a lot or who have had a peritonsillar abscess in the past.

If it’s hard to eat or drink, patients may need IV (intravenous, given into a vein) fluids for hydration. A doctor also will prescribe painkillers and antibiotics. Whenever you take antibiotics, always finish them as prescribed, even if you feel better after a few days. Otherwise, the infection could come back.

People who have a tonsillectomy may need a brief stay in the hospital. That way, doctors can keep an eye on them to make sure everything went as planned.

Can Peritonsillar Abscesses Be Prevented?

To lower your risk of getting an abscess in your tonsils, don’t smoke and make sure you keep your teeth and mouth clean.

But sometimes a peritonsillar abscess is beyond your control. If you think you have an abscess, call your doctor right away. The earlier a doctor diagnoses it, the easier treatment will be.

Medically reviewed by: Elana Pearl Ben-Joseph, MD

Date reviewed: March 2023

Share:

/content/kidshealth/misc/medicalcodes/teens/articles/peritonsillar-abscess

Peritonsillar abscess Information | Mount Sinai

Quinsy; Abscess – peritonsillar; Tonsillitis – abscess

Peritonsillar abscess is a collection of infected material in the area around the tonsils.

The lymphatic system filters fluid from around cells. It is an important part of the immune system. When people refer to swollen glands in the neck, they are usually referring to swollen lymph nodes. Common areas where lymph nodes can be easily felt, especially if they are enlarged, are the groin, armpits (axilla), above the clavicle (supraclavicular), in the neck (cervical), and the back of the head just above hairline (occipital).

Structures of the throat include the esophagus, trachea, epiglottis and tonsils.

Causes

Peritonsillar abscess is a complication of tonsillitis. It is most often caused by a type of bacteria called group A beta-hemolytic streptococcus.

Peritonsillar abscess most often occurs in older children, adolescents, and young adults. The condition is rare now that antibiotics are used to treat tonsillitis.

Symptoms

One or both tonsils become infected. The infection may spread to the area around the tonsil. It can then spread down into the neck and chest. Swollen tissues can block the airway. This is a life-threatening medical emergency.

The abscess can break open (rupture) into the throat. The contents of the abscess can travel into the lungs and cause pneumonia.

Symptoms of peritonsillar abscess include:

• Fever and chills
• Severe throat pain that is usually on one side
• Ear pain on the side of the abscess
• Difficulty opening the mouth, and pain with opening the mouth
• Swallowing problems
• Drooling or inability to swallow saliva
• Facial or neck swelling
• Fever
• Headache
• Muffled voice
• Tender glands of the jaw and throat
• Neck stiffness

Exams and Tests

An exam of the throat often shows swelling on one side and on the roof of the mouth.

The uvula in the back of the throat may be shifted away from the swelling. The neck and throat may be red and swollen on one or both sides.

The following tests may be done:

• Aspiration of the abscess using a needle
• CT scan
• Fiber optic endoscopy to check if the airway is blocked

Treatment

The infection can be treated with antibiotics if it is caught early. If an abscess has developed, it will need to be drained with a needle or by cutting it open. You will be given pain medicine before this is done.

If the infection is very severe, the tonsils will be removed at the same time the abscess is drained, but this is rare. In this case, you will have general anesthesia so you will be asleep and pain-free. 

Outlook (Prognosis)

In most cases, peritonsillar abscess goes away with treatment. The infection may return in the future.

Possible Complications

Complications may include:

• Airway obstruction
• Cellulitis of the jaw, neck, or chest
• Endocarditis (rare)
• Fluid around the lungs (pleural effusion)
• Inflammation around the heart (pericarditis)
• Pneumonia
• Sepsis (infection in the blood)

When to Contact a Medical Professional

Contact your health care provider right away if you have had tonsillitis and you develop symptoms of peritonsillar abscess.

Contact your provider if you have:

• Breathing problems
• Trouble swallowing
• Pain in the chest
• Persistent fever
• Symptoms that get worse

Prevention

Quick treatment of tonsillitis, especially if it is caused by bacteria, may help prevent this condition.

Pappas DE, Hendley JO. Retropharyngeal abscess, lateral pharyngeal (parapharyngeal) abscess, and peritonsillar cellulitis/abscess. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 410.

Roginski MA, Atchinson PR. Upper respiratory tract infections. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 61.

Waage RK. Peritonsillar abscess drainage. In: Fowler GC, ed. Pfenninger and Fowler’s Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 206.

Last reviewed on: 11/29/2022

Reviewed by: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Peritonsillar abscess treatment. Paratonsillar abscess symptoms.

Paratonsillar
or peritonsillar abscess (PTA) is an accumulation of pus between the palatine capsule
tonsils and pharyngeal muscles, that is, in the paratonsillar space. At
If left untreated, the condition poses a threat to life.

Peritonsillar abscess more common
most commonly occurs in adolescents and young adults, but can occasionally occur
in young children and in old age.

Classic
localization of paratonsillar abscess – the space around the upper pole of the palatine tonsil. Also
may occur around the middle or lower tonsil or have
multiple localization.

What causes paratonsillar
abscess?

Generally
an abscess is the result of a bacterial infection, which is most often
becomes a complication of acute pharyngitis or tonsillitis. In more rare cases
peritonsillar abscesses may occur without prior infection in the throat.

Predominant
types of pathogenic bacteria isolated from paratonsillar abscess are Streptococcus pyogenes
(group A streptococcus), Streptococcus anginosus , Staphylococcus aureus and
respiratory anaerobes.

How
Is there a paratonsillar abscess?

One of
the most characteristic symptoms to distinguish paratonsillar abscess from other diseases,
is difficulty opening the mouth (trismus). Sore throat is localized
as a rule, on the one hand, and is so pronounced that sometimes the patient cannot
take not only food, but also water, which can lead to dehydration.

Otherwise, the symptoms of paratonsillar abscess are similar to those of acute tonsillitis or pharyngitis, but more pronounced: increased
body temperature, sore throat aggravated by swallowing, which may
give into the ear, an increase in the submandibular and cervical lymph nodes, a change in voice,
malaise, muscle aches, headache, nausea.

When inflammation spreads to the structures of the larynx, as well as down the
pharyngeal space, breathing difficulties may occur.

How
Is a paratonsillar abscess being diagnosed?

Peritonsillar abscess is dangerous
its complications, therefore, it requires an emergency consultation with a doctor. Main
diagnostic method is the examination of the oropharynx by an otorhinolaryngologist with
assessment of symptoms characteristic of the disease.

Laboratory
assessment is not necessary to make a diagnosis, but may help
determine disease severity and adjust treatment and may include general
blood test, serum electrolytes, rapid test for the determination of b-hemolytic
group A streptococcus, cultured for microflora.

Instrumental
methods (ultrasound of the neck, MRI or CT studies with contrast) can
be required to confirm the presence of an abscess, to diagnose other infections
deep spaces of the neck (retro- or parapharyngeal abscess) or epiglottitis.

Ilinskaya
The hospital is equipped with modern CT and MRI machines. Diagnostic images
are stored in the electronic system of the hospital and are always available to doctors.

What
diseases can proceed as a paratonsillar abscess?

Similar
symptoms may occur in diseases such as:

• Acute tonsillitis or pharyngitis
• Retro- or parapharyngeal abscess
• Mononucleosis
• Tumor of the palatine tonsil

Related with
Therefore, a visit to the doctor is necessary for the correct diagnosis and
development of the optimal treatment strategy.

Treatment of paratonsillar abscess

If available
signs of an abscess, surgical intervention is indicated – drainage of the abscess.
This manipulation can be performed by several methods: needle aspiration,
incision and drainage or tonsillectomy (removal of the tonsils). The choice of one or
different procedure depends on several factors: age, state of mind,
indications for tonsillectomy. Each procedure has its own advantages in
certain situations.

In line
cases, opening of the abscess is indicated simultaneously with the removal of the palatine tonsils :

• recur a few weeks or months after the previous one)
• Peritonsillar abscess with three or more episodes of acute tonsillitis within a year
• Absence
  positive dynamics after the opening of the abscess
• Spread of inflammatory
  process on surrounding organs and tissues

Aspiration
needle and incision can be performed under local anesthesia, however, given
the size of the abscess, the pain of the procedure (local anesthesia does not allow
completely anesthetize the manipulation), the presence of a pronounced gag reflex,
the reluctance of many patients to “be present” at the operation, these manipulations are performed
under short-term general anesthesia. In children, such manipulations are performed
only under general anesthesia. Tonsillectomy is performed only under general
anesthesia in the operating room.

Antibiotic therapy
indicated for all patients with paratonsillar infection. For some patients
antimicrobial therapy alone may be sufficient (there are signs
paratonsillar infection, but no evidence of pus accumulation).

In addition
surgical methods and antibiotic therapy, anti-inflammatory
therapy, pain relief, fluid replacement (hydration) if due to pain
The patient could not eat or drink. As a result, it may be necessary to
hospital.

All rooms
hospital Ilyinsky hospital single or double. Relatives may
visit the patient around the clock. The patient’s vital signs (pulse,
pressure, oxygen saturation, etc.) are controlled by monitors and recorded
electronic system.

Author: Sergey Aleksandrovich Gorbunov Otorhinolaryngologist

Specialists on this issue

PolevGeorgiyAlexandrovich

ENT surgeon, head and neck surgeon

Candidate of Medical Sciences.

ShmelevaLyubovPetrovna

Otorhinolaryngologist

Samarin Nikolay Evgenievich

Otorhinolaryngologist

NersesyanMarinaVladislavovna

Otorhinolaryngologist

Professor, Doctor of Medical Sciences.

Gorbunov Sergey Alexandrovich

Otorhinolaryngologist

Candidate of Medical Sciences.

Treatment of paratonsillar abscess – symptoms and causes

Article rating

4.27 (Votes: 15)

Contents

• Symptoms of paratonsillar abscess

• Treatment of paratonsillar abscess

• Measures to prevent paratonsillar abscess

Peritonsillar abscess is an inflammatory process that occurs in the tissue around the palatine tonsil, which leads to the formation of a purulent cavity and the development of an extensive inflammatory process.

The cause of this disease may be pathogenic microorganisms. Most often it is streptococci, but there may be other pathogens. Often paratonsillar abscess is the result of chronic tonsillitis or tonsillitis, sometimes the pathology appears after dental caries.

Symptoms of paratonsillar abscess

Peritonsillar abscess is characterized by a violation of general well-being, weakness, headache, fever, sometimes up to 40*C. In the throat, on the side of inflammation, pronounced pain occurs, a person experiences severe discomfort when swallowing and difficulty opening the mouth. There may be pain in the ear on the side of the inflammation. In the throat, swelling of the tissues is noted and asymmetry, bulging in the area of ​​\u200b\u200bthe inflammatory process occurs.

If these signs appear, you should immediately consult an otorhinolaryngologist.

Treatment of peritonsillar abscess

Treatment of peritonsillar abscess is carried out by three main methods

• conservative;

• surgical;

• integrated.

Conservative treatment of peritonsillar abscess is effective only in the initial stage. This is a general antibacterial therapy, rinsing with the use of antiseptic and local antibacterial agents.

If the patient comes late for help, conservative methods are not enough, surgical methods of treatment must be used.

In this case, the patient is hospitalized for the opening of the abscess and further treatment, but in exceptional cases, the opening is performed on an outpatient basis.

Before opening an abscess, an otorhinolaryngologist performs local, application anesthesia at the site of inflammation. Then, using a scalpel, the doctor opens the abscess and evacuates the accumulated purulent discharge, after which he rinses the cavity with disinfectant solutions. As a rule, the patient feels relief after a few hours. Be sure, even after the opening of the abscess, general and local antibiotic therapy is prescribed. The next day after the intervention, the patient comes to the appointment to carry out an audit of the site of the autopsy.