Peritonsillar Abscess

Definition

Definition

Peritonsillar abscess is a bacterial infection. It develops on the side of the throat, behind or above the tonsils. The infection causes a pocket of pus to form. This type of abscess usually happens on one side of the throat or the other.

The Tonsils

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Causes

Causes

The abscess is caused by bacteria. It is usually a complication of another illness.

Risk Factors

Risk Factors

It is more common in males and people 20-40 years old. Factors that may increase your chances of developing peritonsillar abscess include:

  • Strep pharyngitis or tonsilitis
  • Pharyngitis or tonsilitis caused by other bacteria
  • Mononucleosis
  • Recent throat infection or dental infection
  • Periodontal disease
  • Smoking

Symptoms

Symptoms

Symptoms may include:

  • Pain in the throat around the tonsil area
  • Tonsil that is moved to one side
  • Fever
  • Drooling and trouble swallowing
  • Bad breath
  • Spasm of the jaw muscle
  • Discomfort in the uvula and soft palate—the tissue at the roof of the mouth
  • Sore and swollen neck glands

Diagnosis

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

You may need to have tissue tested. This can be done with needle aspiration.

You may need to have pictures taken of the inside of your neck. This can be done with:

Treatment

Treatment

Talk with your doctor about the best treatment plan for you. Treatment may include:

Supportive Care

Rest and drink plenty of fluids.

Medication

Antibiotics will be prescribed to treat the infection. Antibiotics can be given in pill form or through an IV. Pain relievers may also be advised.

Aspiration

The abscess may be punctured with a needle. Fluid will be removed. A sample will be sent to the lab for testing. This procedure can be done in the doctor’s office.

Incision and Drainage Procedure

An incision and drainage procedure may be done. While under sedation, a small cut will be made in the abscess. The fluid will be drained.

Tonsillectomy

Atonsillectomy may be recommended if all other treatments fail. This involves removing the affected tonsil. This may also be done if you have had previous peritonsillar infections.

Prevention

Prevention

To help reduce your chances of getting peritonsillar abscess, take the following steps:

  • If you have a throat infection, see your doctor. This is especially important if you have severe or chronic throat infections.
  • If you smoke, talk to your doctor about ways to quit.

RESOURCES:

American Academy of Otolaryngology—Head, and Neck Surgery http://www.entnet.org

Family Doctor—American Academy of Family Physicians http://familydoctor.org

CANADIAN RESOURCES:

The College of Family Physicians of Canada http://www.cfpc.ca

Health Canada http://www.hc-sc.gc.ca

References:

Dunn N, Lane D, Everitt H, Little P. Use of antibiotics for sore throat and incidence of quinsy. Br J Gen Pract. 2007 Jan;57(534):45.

Peritonsillar abscess. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated November 12, 2012. Accessed January 13, 2015.

Steyer T. Peritonsillar abscess: diagnosis and treatment. Am Fam Physician. 2002;65(1):93-97. Available at:
http://www.aafp.org/afp/2002/0101/p93.html
Accessed January 13, 2015.

Last reviewed January 2015 by Michael Woods, MD
Last Updated: 3/15/2013

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