Peritonsillar Abscess

What is a peritonsillar abscess?

A peritonsillar abscess is a swollen, pus-filled pocket that forms near one of your tonsils. It’s usually quite painful and can make it difficult to open your mouth.

Peritonsillar abscess vs. tonsillitis: What’s the difference?

Tonsillitis is an infection of your tonsils, while a peritonsillar abscess is an area of pus-filled tissue next to your tonsils. A peritonsillar abscess is often a complication of tonsillitis, but this isn’t always the case.

Who usually gets peritonsillar abscesses?

Peritonsillar abscesses can affect anyone, but they’re most common in children, adolescents and young adults.

How common are peritonsillar abscesses?

Peritonsillar abscesses occur in about 1 in every 10,000 people. So, while it’s rare overall, it’s still one of the most common head and neck infections.

Is a peritonsillar abscess serious?

A peritonsillar abscess can be serious, especially if it grows so large that it blocks your throat. This can make it difficult to speak, swallow or breathe. Left untreated, the infection can even spread to your mouth, neck, chest or lungs.

What are the symptoms of a peritonsillar abscess?

In most cases, a sore throat is the first sign of a peritonsillar abscess, with additional symptoms developing over the next few days. Other common peritonsillar abscess symptoms include:

• Tonsillitis.
• Fever.
• Chills.
• Swelling of your face and neck.
• Headache.
• Earache.
• Drooling.
• Difficulty swallowing.
• Bad breath.
• Muffled voice or hoarseness.
• A tonsil that’s pushing your uvula (the fleshy, hanging ball in the back of your throat).

What causes peritonsillar abscesses?

In most instances, peritonsillar abscesses are caused by bacteria — and they’re usually a complication of tonsillitis. This happens when the infection spreads from your tonsil to the tissue around it.

There are certain factors that can increase your risk for peritonsillar abscesses, including smoking and gum disease.

Is a peritonsillar abscess contagious?

Yes. Bacteria can be spread through sneezing, coughing or sharing eating utensils.

How are peritonsillar abscesses diagnosed?

Your healthcare provider will perform an examination of your throat, neck and mouth. They may also take a throat culture or blood test. In some cases, they may order imaging tests, such as ultrasound or a CT scan.

How are peritonsillar abscesses treated?

In most cases, a peritonsillar abscess requires surgical drainage and antibiotics. If you get more than one peritonsillar abscesses, you may need a tonsillectomy.

Antibiotics

Your healthcare provider will prescribe antibiotics, which may be given intravenously (through a vein) or taken in pill form. Common oral (by mouth) antibiotics include penicillin, amoxicillin, cephalosporin and clindamycin.

Peritonsillar abscess drainage

In most cases, your healthcare provider will drain the peritonsillar abscess. To do this, they’ll make an incision in the abscess to release the fluid inside of it.

Tonsillectomy

If you have recurrent (repeated) peritonsillar abscesses, your healthcare provider may recommend a tonsillectomy. During this procedure, your tonsils are surgically removed.

Does a peritonsillar abscess need surgery?

In most cases, yes. If it’s the first time you’ve had a peritonsillar abscess, your healthcare provider will likely drain the abscess and prescribe antibiotics. However, if you’ve had recurring (repeated) peritonsillar abscesses, they may recommend a tonsillectomy.

Can I prevent peritonsillar abscesses?

You can’t prevent peritonsillar abscesses altogether. However, you can reduce your risk by:

• Not smoking.
• Practicing good oral hygiene.
• Treating oral infections promptly.

What can I expect if I have a peritonsillar abscess?

If you have a peritonsillar abscess, you may be treated as an outpatient. However, if you have severe swelling that blocks your airway or other complications, you may have the abscess drained in the hospital. If so, you’ll probably need to stay there for a few days. Your healthcare provider will use a combination of treatments to ensure you’re feeling better as soon as possible.

When should I see my healthcare provider?

Anytime you have a severe sore throat, fever, chills or other symptoms related to peritonsillar abscess, schedule an appointment with your healthcare provider. Treating the condition early can help you avoid further complications.

A note from Cleveland Clinic

If you’re having trouble with your tonsils, or if you get tonsillitis repeatedly, you may have a higher risk for peritonsillar abscesses. If you develop signs of a peritonsillar abscess, it’s important to call your healthcare provider immediately. They can treat the issue before it worsens.