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Peritonsillar Abscess

  • 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 condition is more common in young adults. It can also occur in children.
    The Tonsils
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  • Causes

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

    It is more common in males and people 20-40 years old. Factors that 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
    Tell your doctor if you have any of these risk factors.
  • Symptoms

    If you have any of these symptoms, do not assume it is due to peritonsillar abscess. These may be caused by other conditions. Tell your doctor if you have:
    • 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

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Diagnosis and treatment will be based on this.
    Tests may include the following:
    • 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

    Talk with your doctor about the best plan for you. Treatment may include:
    Supportive Care
    Rest and drink plenty of fluids.
    Medication
    Your doctor will prescribe antibiotics to treat the infection. Antibiotics can be given in pill form or through an IV. Pain relievers may also be advised.
    Aspiration
    Your doctor may puncture the abscess 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
    Your doctor may recommend an incision and drainage procedure. While under sedation, the doctor will make a small cut in the abscess. The fluid will be drained.
    Tonsillectomy
    Your doctor may recommend a tonsillectomy if all other treatments fail. This involves removing the affected tonsil. This may also be done if you have had previous peritonsillar infections.
  • 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, quit.
  • RESOURCES

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

    American Academy of Otolaryngology—Head, and Neck Surgery http://www.entnet.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/what.php. Updated November 12, 2012. Accessed February 18, 2014.

    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 February 18, 2013.

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