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 can push the tonsil toward the uvula (the dangling
fleshy object at the back of the mouth). This can block the throat, making it hard
to swallow, speak, and sometimes even breathe.
If you think you have an abscess in the back of your throat, you need to see a
doctor. A peritonsillar abscess that isn't treated can lead to more serious health
What Causes Peritonsillar Abscesses?
Most peritonsillar abscesses are caused by the same 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 around 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, as can
smoking — more good reasons to brush your teeth and not smoke.
What Are the Signs of a Peritonsillar Abscess?
Often, the first sign of a peritonsillar abscess is a sore throat. As the abscess
develops, other symptoms start, such as:
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
a muffled or hoarse voice
An abscess that's not treated quickly can lead to serious problems — for
example, the infection may go into the jaw and neck. If the abscess pops, the infection
may spread to the chest and lead to pneumonia.
How Is a Peritonsillar Abscess Diagnosed?
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 an abscess will get
in the way of your breathing, but if it does, you may need to go to the emergency
room right away.
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.
How Is a Peritonsillar Abscess Treated?
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
If this doesn't work, a patient's tonsils might have to be removed 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, 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. Otherwise, the infection could come back.
People who have a tonsillectomy may need a brief stay in the hospital. That
way, doctors can keep an eye on them to make sure everything went as planned.
Can Peritonsillar Abscesses 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 think you
have an abscess, call your doctor right away. The earlier a doctor diagnoses it, the
easier treatment is likely to be.