Peritonsillar Abscess

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KEY POINTS

• A peritonsillar abscess is a collection of pus around the tonsils and in the throat. Pus is a thick fluid that usually contains white blood cells, dead tissue, and germs.
• Treatment may include antibiotic medicine and a procedure to drain the abscess.
• Ask your healthcare provider how long it will take to recover and how to take care of yourself at home.

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What is a peritonsillar abscess?

A peritonsillar abscess is a collection of pus around the tonsils and in the throat. Pus is a thick fluid that usually contains white blood cells, dead tissue, and germs.

You have 2 tonsils, one on each side of the back of the throat. They are small reddish, oval-shaped masses and may be easy to see especially if they are swollen. They help fight nose and throat infections.

What is the cause?

A peritonsillar abscess is usually an infection. You may get a peritonsillar abscess after you have been sick with:

• Tonsillitis, which is an infection in the tonsils usually caused by bacteria or a virus
• Strep throat

What are the symptoms?

Sore throat is a common symptom that can be just scratchiness or can be intense pain.

Signs and symptoms may include:

• A raw feeling in your throat that causes pain when you breathe, swallow, or talk
• Redness of the throat
• Fever and chills
• Hoarseness
• Pain or trouble swallowing because of swollen tonsils
• Drooling
• Pus in your throat
• Tender, swollen glands in your neck
• Earache (you may feel pain in your ears even though the problem is in your throat)

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• A throat swab to test for a strep infection
• Blood tests
• Ultrasound, which uses sound waves to show pictures of your throat
• CT scan, which uses X-rays and a computer to show detailed pictures of your throat

How is it treated?

Treatment may include:

• Antibiotic medicine
• Needle drainage. Your healthcare provider will remove the fluid and pus from the abscess with a needle. You will have medicine so you won’t feel pain.
• Incision and drainage. Your healthcare provider will make a cut into the tissue and drain the infection. Your provider will leave the area open to drain and it will heal as the infection clears up. You will have medicine so you won’t feel pain.
• Tonsillectomy, which is surgery to remove the tonsils

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Take antibiotics for as long as your healthcare provider prescribes, even if you feel better. If you stop taking the medicine too soon, you may not kill all of the bacteria and you may get sick again. If you have side effects from your medicine, talk to your healthcare provider.
• Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don't take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
• Don’t smoke, and stay away from others who are smoking.
• Get plenty of rest.
• You may want to rest your throat by talking less and eating a diet that is mostly liquid or soft for a day or two. Avoid salty or spicy foods and citrus fruits. Drink extra fluids, such as water, fruit juice, and tea.
• Use a humidifier to put more moisture in the air. Avoid steam vaporizers because they can cause burns. Be sure to keep the humidifier clean, as recommended in the manufacturer's instructions. It's important to keep bacteria and mold from growing in the water container.
• Cough drops may help relieve the soreness.
• Gargling with warm saltwater may help. You can make a saltwater solution by adding 1/4 teaspoon of salt to 8 ounces, or 240 mL, of warm water.

Ask your healthcare provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I prevent a peritonsillar abscess?

The following suggestions may help prevent a peritonsillar abscess:

Use good dental hygiene. Follow your dentist’s instructions for cleaning and flossing your teeth:

• Wash your hands for at least 20 seconds often and especially after using the restroom, coughing, sneezing, or blowing your nose. Also wash your hands before eating or touching your eyes.
• Stay at least 6 feet away from people who are sick, if you can.
• Stay indoors as much as possible on high-pollution days.
• Take care of your health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet and try to keep a healthy weight. If you smoke, try to quit. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Learn ways to manage stress. Exercise according to your healthcare provider's instructions.