Peritonsillar Abscess

A peritonsillar abscess is a pus-filled sac that forms at the base of the throat, precisely near the tonsils. The most common cause of peritonsillar abscess is a complication of tonsillitis. 

A peritonsillar abscess can cause severe pain and swelling in the tonsils, making it difficult for the sufferer to eat and drink. As a result, peritonsillar abscess sufferers are at risk of dehydration.

If not handled well, the infection in the peritonsillar abscess can also spread to the head and neck. In addition, the growing size of the abscess can block the respiratory tract and have fatal consequences.

Causes of Peritonsillar Abscess

As mentioned above, peritonsillar abscess most often occurs due to complications from inflammation of the tonsils (tonsillitis). This condition occurs as a result of Streptococcus group A bacterial infection that spreads to the tissue around the tonsils and causes the formation of pockets filled with pus.

Other bacteria that can cause peritonsillar abscess are Staphylococcus, Pneumococcus, Actinomyces, Neisseria, and Haemophilus.

In rare cases, peritonsillar abscess can also be caused by complications from mononucleosis infection .

There are several factors that can increase a person’s risk of getting a peritonsillar abscess, namely:

• Gum disease, such as periodontitis and gingivitis
• Tonsil stones
• Smoking habits
• Blood cancer, such as chronic lymphocytic leukemia, which causes the immune system to weaken

Symptoms of Peritonsillar Abscess

The main symptom of a peritonsillar abscess is a sore throat. In addition, peritonsillar abscess sufferers can also experience the following symptoms:

• Fever and chills
• Difficulty opening the mouth (trismus) and difficulty swallowing
• Swelling in one of the areas at the base of the throat around the tonsils or near the roof of the mouth
• Ear pain on the same side as the abscess
• Stiff neck (torticollis)
• Hoarse voice
• Headache
• Salivation or drooling
• Swelling of the lymph nodes on the same side as the location of the abscess formation

When should you go to the doctor?

Immediately check with a doctor if the above symptoms appear. Immediate examination and treatment at the IGD also needs to be done if the symptoms of peritonsillar abscess are accompanied by the following conditions:

• Drowned
• Difficulty breathing
• Can’t eat or drink
• Saliva comes out a lot

Diagnosis of Peritonsillar Abscess

To diagnose a peritonsillar abscess, the doctor will ask questions about the patient’s symptoms and health history. After that, the doctor will perform a physical examination, including looking at the throat with the help of a flashlight and a tongue depressor .

Generally, doctors can directly diagnose a peritonsillar abscess by looking at the condition of the patient’s throat and tonsils. However, to ensure it, the doctor can perform a supporting examination, which includes:

• Blood test, to detect signs of infection
• Oral endoscopy, to see the condition of the oral cavity and the surrounding area using a device in the form of a tube with a camera
• CT scan of the head or neck, to get a clearer picture of the location of the abscess and ensure that there is no airway obstruction

Peritonsilla Abscess Treatment

Patients with peritonsillar abscess need to undergo hospital treatment, because the painkillers and antibiotics used are often given through infusion. This is because most patients with peritonsillar abscess cannot take medicine due to trismus or difficulty opening their mouth.

If the patient is drowning because it is difficult to eat and drink, the doctor will first give an infusion of fluids to prevent dehydration.

If the peritonsillar abscess causes a blockage in the respiratory tract, the doctor can make a hole in the throat (tracheostomy) to provide oxygen.

When the patient’s condition has stabilized, the doctor can perform several treatments, such as:

1. Abscess surgery

This action is done to suck out the fluid and pus in the abscess by using a syringe or making a small incision. Before starting a minor operation, the doctor will give a local anesthetic so that the patient does not feel pain during this procedure.

The pus sucked from the abscess can be taken by the doctor to be sent to the laboratory. Next, a culture test will be performed to determine the correct antibiotic drug.

2. Tonsil removal operation

Tonsillectomy or tonsillectomy can be done if minor surgery is ineffective in dealing with peritonsillar abscess. In addition, this surgery is also recommended for patients who suffer from recurrent tonsillitis or who have experienced recurrent peritonsillar abscess.

3. Painkillers and antibiotics

Painkillers are given to relieve pain, both before and after surgery. The doctor will also give antibiotics, such as cephalexin, cefuroxime, clindamycin, or amoxicillin, to kill the germs that cause peritonsillar abscess.

Complications of Peritonsillar Abscess

If not treated immediately, peritonsillar abscess can cause some of the following complications:

• Obstruction of the respiratory tract
• Dehydration due to difficulty eating and drinking
• Cellulitis on the neck, jaw, or chest
• Pneumonia
• Sepsis

If the peritonsillar abscess is caused by Streptococcus group A bacteria, the complications that can occur are:

• Rheumatic heart disease
• Rheumatic fever
• Kidney inflammation (glomerulonephritis)

Prevention of Peritonsillar Abscess

There are several ways that can be done to reduce the risk of peritonsillar abscess, among others:

• Take care of oral health by brushing your teeth and gargling regularly
• No smoking
• Undergo treatment and consume antibiotic medicine until it runs out as recommended by the doctor, if affected by tonsillitis
• Diligently wash your hands and do not touch the nose and mouth area with unwashed hands, so as not to easily get a throat infection

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