Peritonsillar Abscess

A serious and painful INFECTION of the tissues around the tonsils in the back of the THROAT. Unlike TONSILLITIS, which is primarily an infection among children, peritonsillar ABSCESS is most common among adults in early midlife. Doctors are uncertain what causes a peritonsillar abscess to develop, though it will often follow another infection such as tonsillitis, PHARYNGITIS or mononucleosis.

Symptoms emerge suddenly. They include

• severe and usually one-sided PAIN in the throat
• pain in the EAR on the opposite side from the abscess with swallowing
• FEVER
• a whispery, hoarse voice
• neck stiffness and sometimes swelling on the front of the neck
• difficulty swallowing
• inability to fully open the mouth (called trismus)

Symptoms and physical examination typically make the diagnosis, though the doctor may perform a laryngoscopy to more closely examine the throat. After swabbing the peritonsillar area for culture, treatment with intravenous ANTIBIOTIC MEDICATIONS begins. The person remains hospitalized until the swelling goes down and the pain abates, at which point antibiotic therapy shifts to oral doses for the remainder of treatment at home. When the abscess is large or has the potential to interfere with BREATHING, the doctor may choose to surgically open and drain it (under anesthesia). This provides dramatic relief. Most people recover fully and without complications in about two weeks.