Peritonsillar Abscess

A peritonsillar abscess is a collection of pus that forms near the tonsils. It is a complication of a bacterial infection of the tonsils (tonsillitis). The abscess causes one or both tonsils to swell. The infection and swelling may spread to nearby tissues. If tissues swell enough to block the throat, the condition can become life-threatening. It is also dangerous if the abscess bursts and the infection spreads or is breathed into the lungs. The goal is to treat a peritonsillar abscess before it worsens and threatens your health.

Open mouth with tongue depressor holding down tongue, showing tonsils on either side of back of throat. Open mouth with tongue depressor holding down tongue, showing enlarged tonsil on right and abscessed tonsil on left.

Signs and symptoms of peritonsillar abscess

  • Severe sore throat (often worse on one side)

  • Swollen and enlarged tonsils

  • Fever and chills

  • Pain when swallowing or trouble opening the mouth

  • Voice changes 

  • Drooling

  • Swollen or tender glands in the neck

Diagnosing peritonsillar abscess

Your healthcare provider will examine you and look inside your mouth and throat. You will be asked about your symptoms and health history. Tests or procedures may be done as well, including those listed below.

  • Throat swab. This test checks for infection. It is done by wiping a sterile cotton swab in the back of the throat. The swab is then sent to a lab for study.

  • Blood tests. These might be done to check how your body is responding to the infection.

  • Ultrasound or computed tomography (CT) scans. These tests provide images of the abscess. They also help rule out other problems.

  • Needle aspiration. This procedure removes a sample of pus from the abscess with a needle. The sample is then sent to a lab to check for infection. In some cases, all of the pus is removed from the abscess.

Treating peritonsillar abscess

The abscess itself can be treated. Treatment of the underlying infection is also needed. Common treatments are listed below.

  • Medicines. Antibiotics are needed to treat the underlying infection. These may be taken by mouth or given by IV. Pain relievers may also be given, if needed.

  • Drainage of the abscess. A procedure may be needed to drain the pus from the abscess. Pus may be removed from the abscess with a needle (needle aspiration). Or, a small incision is made in the abscess. The pus is then drained and suctioned from the throat and mouth. This is called incision and drainage.

  • Tonsillectomy. This is surgery to remove the tonsils. It may be done if the abscess does not improve with medicines. It may also be done if you have frequent tonsil infections or abscesses.

Recovery and follow-up

Treating the bacterial infection generally relieves the problem. Once the infection resolves, you should recover completely. Follow up with your healthcare provider as directed. And if you develop another throat infection, see your healthcare provider promptly.



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