Peritonsillar abscess

Definition

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

See also: Retropharyngeal abscess

Alternative Names

Quinsy; Abscess - peritonsillar

Causes, incidence, and risk factors

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 is generally a disease of older children, adolescents, and young adults. It has become relatively uncommon since the use of antibiotics to treat tonsillitis.

Symptoms

One or both tonsils become infected. The infection may spread over the roof of the mouth (palate), and to the neck and chest, including the lungs. Swollen tissues may block the airway, which is a life-threatening medical emergency.

The abscess can break open (rupture) into the throat, infecting or further blocking the airway.

Symptoms of peritonsillar abscess include:

• Chills
• Difficulty and pain with opening the mouth
• Drooling
• Facial swelling
• Fever
• Headache
• Hoarseness (occasionally)
• Sore throat (may be severe)
• Tender glands of the jaw and throat

Signs and tests

An examination of the throat and neck may reveal redness and swelling of one or both tonsils, the throat, neck, and chest.

The following tests may be done:

• Aspiration of the abscess
• CT scan

Treatment

If bacteria is causing the infection, you will be given antibiotics. Painkillers may be prescribed, if needed.

The abscess will need to be drained. This requires surgery. Surgery to remove the tonsils (tonsillectomy) may be done.

Expectations (prognosis)

Peritonsillar abscess usually goes away with treatment, although the infection may return in the future.

Complications

• Airway obstruction
• Cellulitis of the jaw, neck, or chest
• Endocarditis (rare)
• Fluid around the lungs (pleural effusion)
• Inflammation around the heart (pericarditis)
• Pneumonia

Calling your health care provider

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

Call your health care provider if you have:

• Cough
• Difficulty breathing
• Pain in the chest
• Persistent fever
• Symptoms that get worse

Prevention

Quickly and completely treating tonsillitis, especially bacterial tonsillitis, may help prevent an abscess.