Peritonsillar Abscess

What Is a Peritonsillar Abscess?


  1. A peritonsillar abscess results when a sore filled with pus forms near the tonsils. It’s usually a complication of tonsillitis.
  2. The abscess is most often caused by a bacterial infection. The symptoms can seem very similar to those of strep throat or tonsillitis.
  3. A peritonsillar abscess can be treated in several different ways, including antibiotics. Full recovery is possible, but it should be treated right away to avoid other potentially serious problems.

A peritonsillar abscess is a bacterial infection that usually begins as a complication of untreated strep throat or tonsillitis. It generally involves a pus-filled pocket that forms near one of your tonsils.

Peritonsillar abscesses are most common in children, adolescents, and young adults. They often occur at the beginning or end of the winter season, when illnesses like strep throat and tonsillitis are most widespread.

Causes of a Peritonsillar Abscess

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Peritonsillar abscesses usually occur as a complication of tonsillitis. If the infection breaks out of a tonsil and spreads to the surrounding area, an abscess can form. Use of antibiotics in the treatment of strep throat and tonsillitis has led to peritonsillar abscesses becoming less common.

Peritonsillar abscesses can also be caused by mononucleosis (commonly referred to as mono) as well as tooth and gum infections. In much rarer cases, it’s possible for peritonsillar abscesses to occur without an infection. This is generally due to the inflammation of the Weber’s glands. These glands are located under your tongue and produce saliva.

Symptoms of a Peritonsillar Abscess

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The symptoms of a peritonsillar abscess are similar to those of tonsillitis and strep throat. However, with this condition, you may actually be able to see the abscess towards the back of your throat. It looks like a swollen, whitish blister or boil. Symptoms of a peritonsillar abscess include:

  • infection in one or both tonsils
  • fevers or chills
  • difficulty opening the mouth fully
  • difficulty swallowing
  • difficulty swallowing saliva (drooling)
  • swelling of the face or neck
  • headache
  • muffled voice
  • sore throat (usually worse on one side)
  • swollen glands in the throat and jaw (tender to the touch) and ear pain on the side of the sore throat
  • bad breath

Peritonsillar abscesses could cause potentially severe symptoms or complications. These rarer and more serious symptoms include:

  • infected lungs
  • obstructed (blocked) airway
  • spreading of infection to throat, mouth, neck, and chest
  • rupture of the abscess

If the abscess ruptures, it can carry infection throughout the body. It can also block the airway even more.

Even though some of these symptoms may be signs of other problems, such as strep throat, you should contact your doctor so they can make the final determination.

Diagnosing a Peritonsillar Abscess

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To diagnose a peritonsillar abscess, your doctor will first perform an examination of your mouth and throat. They may take a throat culture or a blood test to diagnose your condition. Signs of an abscess include:

  • swelling on one side of the throat
  • swelling on the roof of the mouth
  • redness and swelling of the throat and neck

Lymph nodes are often enlarged on the same side.

Your doctor might also order a CT scan or MRI to see the abscess more closely. They might also use a needle to draw fluid from the abscess. This fluid will be tested to check if there is an infection.

Preventing Peritonsillar Abscesses from Developing

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To prevent an abscess, it helps to begin treatment for tonsillitis immediately. Your chance of getting an abscess increases when treatment for tonsillitis is delayed.

You should also get treatment right away if you contract mono to help prevent further complications. Make sure to brush your teeth and get your dental checkups to keep your teeth healthy. Smokers are also more prone to peritonsillar abscesses. Keeping your mouth clean and healthy and not smoking can help to reduce your chance of developing an abscess.

Treating a Peritonsillar Abscess

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Antibiotics are the most common form of treatment for a peritonsillar abscess. Your doctor may also drain the pus in the abscess to help the antibiotics work properly. This is done by lancing (or cutting) into the abscess to release fluids. A needle can also be used. Note that such procedures are usually done by an ENT (ear, nose, and throat) surgeon.

If you are unable to eat or drink, you may have to receive fluids for hydration intravenously (through an IV). Painkillers may be prescribed also if you are experiencing a great amount of pain.

As with chronic strep throat and tonsillitis, when abscesses are reoccurring, your doctor might recommend removing the tonsils to avoid future and more severe infections.

What Is the Long-Term Outlook for Peritonsillar Abscesses?

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If it’s treated, a peritonsillar abscess normally goes away without causing any more problems. However, you could get the infection again in the future.

If it isn’t treated quickly, longer term potential complications from a peritonsillar abscess include:

  • obstruction of the airway
  • bacterial infection in the jaw, neck, or chest
  • fluid around the lungs
  • pneumonia
  • inflammation around the heart

If you are having problems with your tonsils, talk to your doctor about possibly removing them. Pay attention to any pain or changes in your throat area and remember that the key to treating peritonsillar abscess is early detection.

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