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    Peritonsillar abscess

    Quinsy; Abscess - peritonsillar

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

    Causes

    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 acondition 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 infectionusually spreadsbehind the tonsiland can then spread downinto the neck and chest. Swollen tissuescan block the airway. This isa life-threatening medical emergency.

    The abscess can break open (rupture) into the throat. Thecontent of the abscess can then travel into the lungs and cause pneumonia.

    Symptoms of peritonsillar abscess include:

    • Fever and chills
    • Severe throat pain that is usually on one side
    • Difficulty opening the mouth, and pain with opening the mouth
    • Difficulty swallowing
    • Drooling or inability to swallow saliva
    • Facial or neckswelling
    • Fever
    • Headache
    • Muffled voice
    • Tender glands of the jaw and throat

    Exams 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:

    • Aspiration of the abscess using a needle
    • CT scan

    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. You will be given pain medicine before this is done.

    Sometimes, at the same time the abscessis drained, the tonsils will be removed. In this case, you will be put to sleep with anesthesia.

    Outlook (Prognosis)

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

    Possible Complications

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

    When to Contact a Medical Professional

    Call your health care provider right awayif 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

    Treating tonsillitis, especially bacterial tonsillitis, quickly and completelymay 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: Elsevier Mosby;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: Elsevier Mosby;2009:chap 73.

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    • Lymphatic system

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    • Throat anatomy

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      • Lymphatic system

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      • Throat anatomy

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      Self Care

        Tests for Peritonsillar abscess

        Review Date: 11/9/2012

        Reviewed By: Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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