Peritonsillar Abscess
All the information about the causes, symptoms, and treatments of pus accumulation near the tonsils.
Symptoms and Causes
A peritonsillar abscess is an accumulation of pus beneath the tissue surrounding the tonsils. These abscesses are located at the back of the mouth, near the throat; therefore, if the area becomes inflamed, it may cause breathing difficulties.
It is usually the result of severe or chronic tonsillitis due to the presence of an excessive bacterial load. The widespread use of antibiotics has made peritonsillar abscess an uncommon condition today.
When treated promptly, the prognosis for a peritonsillar abscess is favorable, and patients recover completely. To prevent complications, it is essential to seek emergency medical attention at the slightest indication of this type of abscess.
Symptoms
The characteristic symptoms of a peritonsillar abscess include:
- Redness and swelling of the tonsils.
- Severe pain on one side of the throat.
- Difficulty opening the mouth.
- Ear pain.
- Difficulty swallowing.
- Drooling due to difficulty swallowing saliva.
- Chills.
- Fever.
- Hoarseness.
- Halitosis.
- Swollen lymph nodes.
Causes
A peritonsillar abscess is one of the possible consequences of tonsillitis, particularly when it is severe or chronic. The causative bacterium is most commonly Streptococcus.
Risk Factors
Factors that increase the risk of developing a peritonsillar abscess include:
- Previous tonsillitis or tonsillopharyngitis.
- Age: it is more common in children, adolescents, and young adults.
- Smoking.
- Gum diseases such as periodontitis or gingivitis.
Complications
A peritonsillar abscess may cause serious complications, including:
- Airway obstruction due to tissue swelling or displacement of the pus collection toward the uvula.
- Pneumonia resulting from rupture of the abscess and subsequent aspiration of pus into the lungs.
Prevention
Peritonsillar abscesses cannot be prevented; however, maintaining good oral hygiene and avoiding smoking are recommended to reduce the risk.
Which specialist treats peritonsillar abscess?
Peritonsillar abscess is diagnosed and treated within the specialty of Otorhinolaryngology.
Diagnosis
A peritonsillar abscess is usually diagnosed following a physical examination in which the specialist assesses the condition of the throat, evaluates the symptoms, and reviews the patient's medical history.
In some cases, a throat swab culture is performed to identify the type of bacteria responsible and determine the most appropriate treatment.
When the diagnosis is unclear and there is uncertainty regarding the patient's condition, a computed tomography (CT) scan of the throat is performed to obtain detailed images of the tissues.
Treatment
The standard treatment for a peritonsillar abscess is drainage to remove the pus from the abscess cavity. Two different techniques may be used:
- Needle aspiration: This is a minimally invasive procedure. A needle is inserted into the most prominent part of the abscess, and the pus is withdrawn using a syringe. In cases of significant inflammation, ultrasound guidance may be used during the procedure to avoid injury to the carotid artery.
- Incision and drainage: An anteroposterior incision is made in the most inflamed area of the abscess, and the fluid is aspirated using a catheter. Some pus or blood may drain into the mouth, requiring the patient to spit it out. The cavity is then cleaned and left open to heal by secondary intention. During the following days, the area should be kept clean by gargling with warm water.
Following drainage, patients typically experience immediate relief, although complete recovery generally takes one to two weeks. During this period, antibiotics are administered to treat the infection.
