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The Tonsils  
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Definition  

Peritonsillar abscess is a bacterial infection. It develops in the back of the throat, behind or above the tonsils. The infection causes a pocket of pus to form. The tonsil area becomes tender. Fever, trouble swallowing, jaw spasms, and bad breath may also occur. This type of abscess usually happens on one side of the throat or the other. The condition is more common in young adults. It can also occur in children.

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Causes  

The abscess is caused by bacteria. It is usually a complication of another illness, such as:

  • Strep pharyngitis—swelling and inflammation at the back of the throat
  • Tonsilitis
  • Pharyngitis or tonsilitis caused by other bacteria
  • Mononucleosis
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Risk Factors  

Factors that increase your chances of developing peritonsillar abscess include:

  • Age: 20-40 years
  • Gender: male
  • Recent throat infection or dental infection
  • Periodontal disease
  • Smoking

Tell your doctor if you have any of these risk factors.

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Symptoms  

If you have any of these symptoms, do not assume it is due to peritonsillar abscess. These may be caused by other conditions. Tell your doctor if you have:

  • Tonsils that are moved to one side
  • Fever
  • Drooling
  • Bad breath
  • Spasm of the jaw muscle
  • Discomfort in the uvula and soft palate—the tissue at the roof of the mouth
  • Difficulty swallowing
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Diagnosis  

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include the following:

  • You may need to have tissue tested. This can be done with needle aspiration.
  • You may need to have pictures taken of the inside of your neck. This can be done with:
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Treatment  

Talk with your doctor about the best plan for you. Options include the following:

Supportive Care  

To recover, rest and drink plenty of fluids.

Medication  

Your doctor will prescribe antibiotics to treat the infection. Antibiotics can be given in pill form or through an IV. Pain relievers may also be advised.

Aspiration  

Your doctor may puncture the abscess with a needle. Fluid will be removed. A sample will be sent to the lab for testing. This procedure can be done in the doctor’s office.

Incision and Drainage Procedure  

Your doctor may recommend an incision and drainage procedure. While under sedation, the doctor will make a small cut in the abscess. The fluid will be drained.

Tonsillectomy  

Your doctor may recommend a tonsillectomy if all other treatments fail. This involves removing the affected tonsil.

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Prevention  

To help reduce your chances of getting peritonsillar abscess, take the following steps:

  • If you have an infection, see your doctor. This is especially important if you have severe or chronic throat infections.
  • If you smoke, quit.