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Peritonsillar Abscess

What Is a Peritonsillar Abscess?

A peritonsillar abscess is an area of pus-filled tissue at the back of the mouth, next to one of the tonsils. The abscess can be very painful and can make it difficult to open the mouth. It can also cause swelling that may push a person's tonsil toward the uvula (the dangling fleshy object at the back of the mouth). If this happens, it can become hard to swallow, speak, and maybe even breathe.

Peritonsillar Abscess

If you think you have an abscess in the back of your throat, you'll want to see a doctor. If a peritonsillar abscess isn't treated, it can lead to more serious health problems.

What Causes Peritonsillar Abscesses?

Peritonsillar abscesses are most often caused by the same type of bacteria that cause strep throat. Sometimes, other types of bacteria are involved.

Peritonsillar abscesses usually happen as a complication of tonsillitis. If the infection breaks out of a tonsil and gets into the space surrounding it, an abscess can form. Luckily, peritonsillar abscesses aren't that common these days because doctors use antibiotics to treat tonsillitis.

Tooth and gum disease can increase the chances of a peritonsillar abscess forming, as can smoking — more good reasons to brush your teeth and avoid cigarettes.

What Are the Signs Someone Has It?

Often, the first sign of a peritonsillar abscess is a sore throat. As the abscess develops, other symptoms will appear. The most common ones include:

  • red, swollen tonsils
  • a tonsil that's pushing against the uvula
  • tender, swollen glands (lymph nodes) on one side of the neck
  • severe pain on one side of the throat
  • difficulty and pain when swallowing or opening the mouth
  • fever and chills
  • headache
  • earache
  • drooling
  • a muffled or hoarse voice

A peritonsillar abscess that goes untreated for a long period of time can lead to serious complications —for example, the infection may extend into the jaw, neck, and chest, or even the lungs, which can lead to pneumonia.

What Should You Do?

Call your doctor if you have a sore throat with a fever or any of the other problems that can be caused by a peritonsillar abscess. It's rare that a peritonsillar abscess will get in the way of your breathing, but if it does, you may need to go to the emergency room right away.

What Do Doctors Do?

The doctor will examine your mouth, throat, and neck. He or she also may take a throat culture and a blood test. On rare occasions, a doctor may order a CT scan or ultrasound.

The usual treatment for a peritonsillar abscess involves having a doctor drain the abscess. The doctor does this either by withdrawing the pus with a needle (called aspiration) or making a small cut in the abscess with a scalpel so the pus can drain out.

If this doesn't work, a patient may need to have his or her tonsils removed, which is done in a procedure called a tonsillectomy. This is especially true for people who have had tonsillitis a lot or who have had a peritonsillar abscess in the past.

If it's hard to eat or drink, patients may need IV (intravenous, which means given into a vein) fluids for hydration. A doctor also will prescribe painkillers and antibiotics. Whenever you take antibiotics, always finish the full course of the medicine as prescribed, even if you feel better after a few days.

People who are treated with aspiration or have a tonsillectomy may need to stay in the hospital. That way, doctors can keep an eye on them to make sure everything went as planned.

Can Peritonsillar Abscess Be Prevented?

You can take a few precautions to lower your risk of getting an abscess in your tonsils — like not smoking and making sure you keep your teeth and mouth clean.

But sometimes a peritonsillar abscess is beyond your control. If you suspect you have an abscess, call your doctor right away. The earlier a doctor diagnoses it, the less involved the treatment is likely to be.

Reviewed by: Scott A. Barron, MD
Date reviewed: January 2015