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Peritonsillar abscess

Quinsy; Abscess - peritonsillar; Tonsillitis - abscess

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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.

Definition

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

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:

Outlook (Prognosis)

Peritonsillar abscess goes away with treatment in most cases. The infection may return in the future.

Possible Complications

Complications may include:

Prevention

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

Symptoms

One or both tonsils become infected. The infection most often spreads to behind 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 content 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

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. 

When to Contact a Medical Professional

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

Call your provider if you have:

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

Review Date: 8/17/2016
Reviewed By: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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