Peritonsillar abscesses are usually caused by a bacterial infection.
An abscess in your throat is a collection (or pocket) of pus in the space (peritonsillar space) that lies between each tonsil and wall of the throat. Medically, it is known as peritonsillar abscess or quinsy.
Peritonsillar abscesses are usually caused by a bacterial infection. The bacteria are usually either Streptococci (strep throat, most common) or Staphylococci.
Peritonsillar abscess is most commonly seen to occur as a complication of tonsillitis (untreated or chronic).
Factors that can put you at risk for peritonsillar abscess include:
- Infectious mononucleosis (also known as mono or the kissing disease)
- Dental infection (such as gum infections: periodontitis and gingivitis)
- Smoking
- Chronic lymphocytic leukemia (CLL), which is a type of blood cancer
- Tonsilloliths (stones or calcium deposits in the tonsils)
Peritonsillar abscesses most often are found in adolescents and young adults.
What are the signs and symptoms of a peritonsillar abscess?
Peritonsillar abscess is generally preceded by a sore throat (tonsillitis) that worsens if left untreated. The signs and symptoms include:
- Redness and swelling in the throat
- Painful/difficulty swallowing
- Trouble speaking
- Fever
- Chills
- Headache
- Swollen lymph nodes (glands) in the neck
- Swelling of the face
- Drooling
- Dehydration (pain makes the patient avoid eating food and drinking liquids)
- Hot potato voice (a voice that sounds as if the person is speaking with hot potatoes in their mouth)
- Halitosis (bad breath)
- Difficulty breathing
How is a peritonsillar abscess diagnosed?
Your doctor will ask you to open your mouth as widely as you can so that they can examine the inside of your mouth and throat. They can collect a sample of the pus from the abscess and send it to the laboratory to find out the bacteria that caused it.
The doctor can put a long, flexible tube-like camera with light (endoscope) for clear visualization of your tonsils and the surrounding structures.
To know the extent of the infection, your doctor may order an ultrasonography or computerized tomography (CT) scan of your neck region.
How is a peritonsillar abscess treated?
Antibiotics: Your doctor will put you on antibiotics for 3-7 days. In mild cases, you can take them in the form of pills. If the infection is severe, your doctor will administer the antibiotics through your vein.
Drainage of abscess: Peritonsillar abscesses that do not respond to antibiotic therapy need to be drained surgically. This procedure can be done in a doctor’s office or an operating room, depending on your health status. Your doctor may inject medication into your throat to numb the area or put you on sedating medicine that makes you sleep throughout the procedure. Next, they drain the abscess to remove all the pus and do sterile dressing of the area.
Tonsillectomy: If tonsillitis or a peritonsillar abscess keeps recurring, your doctor may recommend your tonsils to be removed surgically. The surgery is known as tonsillectomy.
What are the complications of peritonsillar abscess?
Treatment is generally successful at resolving the peritonsillar abscess and complications are rare.
Possible risks of a peritonsillar abscess include: