What is a Peritonsillar Abscess?

J.M. Willhite

Peritonsillar abscess is a secondary, infectious condition that occurs in the presence of tonsillitis. Caused by group A beta-hemolytic streptococcus bacteria, a peritonsillar abscess forms when infectious puss accumulates in the delicate tissues of the tonsils. Treatment generally involves draining the abscess and administering antibiotic and analgesic medications to fight infection and alleviate discomfort. Complications associated with this condition include impaired respiration, cellulitis, and pneumonia.

A peritonsillar abscess may occur during tonsilitis.
A peritonsillar abscess may occur during tonsilitis.

Tonsillitis is a condition initially triggered by exposure to a bacterial or viral infection, such as group A streptococcus, which leads to a settling of infection within the tonsils. Those who develop tonsillitis generally experience throat discomfort, fever, and difficulty swallowing. As the infection progresses, it can impair one’s ability to breathe properly and may cause an individual to develop pronounced fatigue and achiness.

A visual examination can help diagnose a peritonsillar abscess.
A visual examination can help diagnose a peritonsillar abscess.

Exposure to group A beta-hemolytic streptococcus can sometimes complicate a tonsillitis infection by contributing to the development of a peritonsillar abscess. Essentially a physical accumulation of infectious material, a peritonsillar abscess can affect one or both tonsils depending on the severity of infection. A diagnosis is usually made with a visual examination of the abscess that is verified with the administration of an aspiration procedure where a portion of the abscess is removed for laboratory analysis.

In addition to the symptoms experienced with tonsillitis, individuals who develop this complication often exhibit a progressive worsening of symptoms. Abscess formation may trigger fluid build-up that contributes to facial swelling that causes discomfort and impairs one’s ability to open his or her mouth or induces drooling. Others may also develop jaw sensitivity or hoarseness.

If left untreated, a peritonsillar abscess can contribute to the development of a variety of complications. As the abscess grows, if it does not rupture, it may obstruct one’s airway and restrict respiration. Infection that contributed to the abscess’ formation may spread to other parts of the head, including the neck and jaw, leading to the development of cellulitis, which places the individual at risk for meningitis. Additional complications may include pneumonia and pericarditis, which is an inflammation of the sac that surrounds the heart, both of which may lead to organ failure and premature death.

Treatment for peritonsillar abscess generally involves a surgical procedure to drain the abscess and prevent further complications. In most instances, a tonsillectomy may also be performed once the abscess is removed. Antibiotic and analgesic medications may also be prescribed to eliminate infection and ease discomfort following surgery.

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Discussion Comments

Laurelann25

I have a bump that has a white head protruding from the right side of my throat towards my tonsil. I don't have a sore throat or fever. I did have problems with the inside of my nose burning, sneezing and an extremely runny nose, but it seems to have gotten somewhat better.

I decided to look into my throat when this went into the second week and that's when I saw this bump. I called the doctor and sent a picture. They told me it looked like a peritonsillar abscess and to just gargle with salt water and a bit of peroxide to kill germs. Also, to get allergy medication. They said to wait till Monday to see if it broke open or disappeared.

I now see a little cluster of white spots along my jawline towards the back of my throat where I no longer have teeth. Should I be calling the doctor back and requesting again to be seen in person? I am concerned that this is related to an underlying condition or is the beginning of one.

If you have any suggestions, I would really appreciate them. Thank you.

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