Peritonsillar abscess


An abscess is a swollen mass that contains the pus and debris of dead cells. An abscess can occur in any part of the body, but armpits, groin, anus and vagina, spine base, and tooth and tonsil areas are the common places where it can show up. Abscesses are mainly caused by bacterial infection due to inflammation of the hair follicles, obstruction of the sweat glands, and other inflammations that may result from a minor damage to the affected skin.  The body’s immune system puts a defense against the invading bacteria and more pus, bacteria and debris are formed. The abscess grows and the increasing inflammation and pressure causes pain.


When an abscess is formed next to the tonsils or throat areas, it’s referred as Peritonsillar abscess. In severe cases, the patient may face difficulties in speaking, swallowing and even breathing due to blocked throat. Peritonsillar abscess is mainly a complication of tonsillitis (an infection of the tissues around the tonsils), but periodontitis, gingivitis and other chronic infections in the mouth may also cause it to show up. People with chronic tonsillitis, chronic lymphocytic leukemia, infectious mononucleosis, and tonsilloliths (calcium deposits in the throat) are the known risk groups of Peritonsillar abscess.  It’s more common in adults and rarely occurs in infants or young kids. Smoking and other pollutants in the environment are very helpful to streptococcal bacteria that cause it.

Unless the patient is already suffering from tonsillitis, a sore throat is probably the first symptom of peritonsillar abscess. Other symptoms appear within two to five days. The signs and symptoms of peritonsillar abscess include:

  • Pain and difficulty in swallowing saliva, water, and food
  • Inflammation in the throat, typically on one side
  • Pain in the ear, on the swelling side
  • Fever
  • Muffled voice
  • Enlarged and tender lymph glands
  • Spasm in the muscles of jaws and the neck

If you feel a sore throat with peritonsillar abscess associated symptoms like swallowing, speaking and breathing difficulties or other signs of potential airway obstruction, you should promptly consult your doctor. It’s not advisable to waste your time in any kinds of home treatments because they won’t be very effective in a peritonsillar abscess. The pus and debris that is trapped inside an abscess have to be drained for its healing. Your doctor will also ensure that other upper respiratory tract complications like epiglottitis, retropharyngeal abscess or peritonsillar cellulitis are not present.

Severe cases of the peritonsillar abscess may cause medical emergencies, particularly when the patient’s airway is blocked due to inflamed abscess. In such cases, the doctors will insert a needle in the pus pocket and drain the trapped fluid to restore a normal breathing. In other cases, your doctor will recommend medications to reduce swelling and inflammation, but needle aspiration will still be required to drain the trapped pus.

Once the pus is drained, antibiotics are used as the main line of treatment for a peritonsillar abscess. Your doctor may recommend a swab culture to identify the bacteria in the pus. You may also be tested for mononucleosis (caused by a virus) as about 20 percent peritonsillar abscess is associated with this virus.  A proper treatment of uncomplicated peritonsillar abscess will make you recover in no time, but if ignored, further complications like dehydration, airway blockage, bleeding, pneumonia, meningitis, and sepsis may occur. People with compromised immunity, HIV infection, and cancer are more likely to develop these complications.

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