Peritonsillar Abscess

A peritonsillar abscess is a serious complication of tonsillitis, where an abscess forms beside the tonsils.

Definition

A peritonsillar abscess is a collection of pus that forms in the tissues beside the tonsils, specifically in the peritonsillar space. This space is located between the tonsil and the pharyngeal muscles.

Causes

The most common cause of a peritonsillar abscess is bacterial infection, typically with Streptococcus pyogenes or other streptococcal species. The infection spreads from the tonsils to the surrounding tissues, leading to the formation of an abscess.

Symptoms

Common symptoms of a peritonsillar abscess include:

• Severe throat pain, usually on one side
• Difficulty swallowing (dysphagia)
• Fever
• Swollen and tender lymph nodes in the neck
• Bad breath (halitosis)
• A feeling of something stuck in the throat
• Muffled or changed voice
• Trismus, or lockjaw, due to pain and swelling

Diagnosis

Diagnosis is typically made based on a combination of:

• Medical history and physical examination
• Throat swab or culture to identify the causative bacteria
• Imaging studies, such as CT scans or ultrasound, to confirm the presence of an abscess

Treatment

Treatment for a peritonsillar abscess usually involves:

• Antibiotics to treat the underlying bacterial infection
• Drainage of the abscess, either through needle aspiration or surgical incision and drainage
• Pain management with analgesics and anti-inflammatory medications
• Supportive care, such as hydration and rest

Complications

If left untreated, a peritonsillar abscess can lead to serious complications, including:

• Abscess rupture, leading to aspiration of pus into the lungs
• Spread of infection to other parts of the head and neck
• Mediatinitis, or inflammation of the tissues in the mediastinum (the area between the lungs)
• Ludwig's angina, a severe infection of the submandibular space

Prevention

Prevention of peritonsillar abscess involves:

• Practicing good hygiene, such as frequent handwashing and avoiding close contact with people who have streptococcal infections
• Getting vaccinated against streptococcal infections, if recommended by a healthcare provider
• Treating tonsillitis promptly and effectively to prevent complications