Summary about Disease
A peritonsillar abscess (PTA) is a collection of pus located in the space between the tonsil and the pharynx (the area at the back of the throat). It is usually a complication of tonsillitis (infection of the tonsils). The infection spreads from the tonsil to the surrounding tissue, creating an abscess. It's a relatively common condition, particularly in adolescents and young adults.
Symptoms
Severe sore throat, usually worse on one side
Difficulty swallowing (dysphagia)
Pain when swallowing (odynophagia)
Fever and chills
Muffled or "hot potato" voice
Drooling
Difficulty opening the mouth fully (trismus)
Swelling in the neck or face
Ear pain on the affected side
Bad breath (halitosis)
Deviation of the uvula (the fleshy part that hangs down in the back of the throat) to the opposite side.
Causes
Peritonsillar abscesses are typically caused by a bacterial infection that spreads from the tonsils to the surrounding tissue. The most common bacteria involved include:
Streptococcus pyogenes (Group A Streptococcus)
Staphylococcus aureus
Haemophilus influenzae
Anaerobic bacteria (bacteria that can survive without oxygen) Tonsillitis that is not treated or does not respond well to treatment can lead to a PTA. Sometimes, the infection starts as cellulitis (inflammation of the soft tissue) in the peritonsillar space and progresses to abscess formation.
Medicine Used
4. Medicine used
Antibiotics: Antibiotics are essential to treat the bacterial infection. Common antibiotics used include:
Penicillin or amoxicillin (often with clavulanate)
Clindamycin (especially if penicillin allergy)
Metronidazole (to cover anaerobic bacteria)
Pain relievers: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain and fever.
Corticosteroids: Sometimes, a short course of corticosteroids (e.g., prednisone) may be prescribed to reduce swelling and inflammation.
Is Communicable
The abscess itself is not communicable. However, the underlying bacterial infection (like strep throat) that leads to tonsillitis and potentially the abscess can be contagious. The bacteria are typically spread through respiratory droplets (coughing, sneezing).
Precautions
Good hygiene: Frequent handwashing with soap and water, especially after coughing or sneezing.
Avoid sharing: Avoid sharing eating utensils, cups, or personal items with others, especially if you have a sore throat.
Cough etiquette: Cover your mouth and nose when coughing or sneezing.
Stay home: If you have symptoms of a sore throat or infection, stay home from school or work to prevent spreading the illness.
Complete antibiotic course: If prescribed antibiotics, take the full course even if you start feeling better to ensure the infection is completely eradicated.
Follow medical advice: Follow all instructions given by your doctor regarding treatment and follow-up care.
How long does an outbreak last?
Without treatment, a peritonsillar abscess can persist for several days to weeks and can worsen. With prompt treatment (drainage of the abscess and antibiotics), symptoms should improve within 24-48 hours. The entire course of antibiotics usually lasts 7-14 days.
How is it diagnosed?
Physical examination: A doctor will examine the throat, looking for swelling, redness, and deviation of the uvula. They will also palpate the neck for swollen lymph nodes.
Needle aspiration or incision and drainage: This is both diagnostic and therapeutic. A needle or scalpel is used to drain the pus from the abscess. The drained fluid can be sent to a lab for culture to identify the specific bacteria.
Imaging studies: In some cases, a CT scan or ultrasound of the neck may be used to confirm the diagnosis and rule out other conditions, especially if the diagnosis is unclear on physical exam.
Timeline of Symptoms
9. Timeline of symptoms The timeline can vary, but a typical progression might look like this:
Day 1-2: Sore throat begins, often mild at first.
Day 3-4: Sore throat worsens, becoming more severe on one side. Difficulty swallowing may start.
Day 5-7: Pain becomes intense, and other symptoms develop, such as fever, muffled voice, trismus, and drooling. Deviation of the uvula may be noticeable. It's important to seek medical attention as soon as possible if symptoms worsen rapidly.
Important Considerations
Airway obstruction: A PTA can potentially obstruct the airway, especially in severe cases. Difficulty breathing is a medical emergency and requires immediate attention.
Dehydration: Difficulty swallowing can lead to dehydration. It's important to stay hydrated by drinking fluids as tolerated. Intravenous fluids may be necessary in some cases.
Spread of infection: If left untreated, the infection can spread to other areas of the body, leading to serious complications, such as sepsis (blood infection).
Recurrence: Some individuals may experience recurrent peritonsillar abscesses. In these cases, a tonsillectomy (surgical removal of the tonsils) may be considered.
Dental Health: Bacteria can easily form in the throat that gets infected easily and can lead to problems in teeth, such as gingivitis.