Peritonsillar abscess

Lymphatic system

The lymphatic system filters fluid from around cells. It is an important part of the immune system. When people refer to swollen glands in the neck, they are usually referring to swollen lymph nodes. Common areas where lymph nodes can be easily felt, especially if they are enlarged, are: the groin, armpits (axilla), above the clavicle (supraclavicular), in the neck (cervical), and the back of the head just above hairline (occipital).

Also known as: Quinsy and Abscess - peritonsillar

Definition

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

See also:

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 usually a disease of older children, adolescents, and young adults. It has become uncommon with 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 opening the mouth, and pain with opening the mouth
  • Difficulty swallowing
  • Drooling or inability to swallow saliva
  • Facial swelling
  • Fever
  • Headache
  • Muffled voice
  • Sore throat (may be severe and is usually on one side)
  • Tender glands of the jaw and throat

Signs and tests

An examination 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:

Treatment

If the infection is caught early, you will be given antibiotics. More likely, if an abscess has developed, it will need to be drained with a needle or by cutting it open.

Sometimes, the abscess may be drained and the tonsils removed at the same time. You will be prescribed painkillers.

Expectations (prognosis)

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

Complications

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:

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

Prevention

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

References

Shirley WP, Woolley AL, Wiatrak BJ. Pharyngitis and adenotonsillar disease. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010:chap 196.

Melio FR. Upper respiratory tract infections. In: Marx JA, Hockberger RS, Wallis RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 73.

See also:

  • Disease

    Endocarditis

    Heart, section through the middle

    Endocarditis is inflammation of the inside lining of the heart chambers and heart valves (endocardium). See also:

  • Disease

    Pleural effusion

    Lungs

    A pleural effusion is a buildup of fluid between the layers of tissue that line the lungs and chest cavity.

  • Disease

    Cellulitis

    Cellulitis

    Cellulitis is a common skin infection caused by bacteria. See also:

  • Disease

    Tonsillitis

    Lymphatic system

    Tonsillitis is inflammation (swelling) of the tonsils. See also:

  • Disease

    Pneumonia

    Pneumococci organism

    Pneumonia is a respiratory condition in which there is infection of the lung. Community-acquired pneumonia refers to pneumonia in people who have not recently been in the hospital or another health care facility (nursing home, rehabilitation facility). See also:

  • Disease

    Retropharyngeal abscess

    Throat anatomy

    Retropharyngeal abscess is a collection of pus in the tissues in the back of the throat. It is a potentially life-threatening medical condition. See also:

  • Symptoms

    Breathing difficulty

    Lungs

    Breathing difficulty involves a sensation of difficult or uncomfortable breathing or a feeling of not getting enough air. See also:

  • Disease

    Pericarditis

    Pericarditis

    Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed. See also:

  • Disease

    Abscess

    An abscess is a collection of pus in any part of the body that, in most cases, causes swelling and inflammation around it.

Review date:
November 23, 2010
Reviewed by:
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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