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Peritonsillar Abscess


A peritonsillar abscess is a bag filled with pus that forms at the base of the throat, to be precise, near the tonsils. A peritonsillar abscess is the most common cause of this complication of tonsillitis. 

A peritonsillar abscess can cause severe pain and swelling of the tonsils, making it difficult for sufferers to eat and drink. As a result, patients with peritonsillar abscesses are at risk of becoming dehydrated. 

Peritonsillar Abscess

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

Causes of Peritonsillar Abscess

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

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

In rare cases, peritonsillar abscesses can also be caused by complications from infectious mononucleosis. 

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

  • Gum disease, such as periodontitis and gingivitis
  • Tonsil stones
  • Smoking habit
  • Blood cancers, such as chronic lymphocytic leukemia, which cause a weakened immune system,

Symptoms of Peritonsillar Abscess

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

  • Fever and chills
  • Difficulty opening the mouth (trismus) and difficulty swallowing
  • Swelling in one area of the base of the throat around the tonsils
  • Ear pain on one side is the same as the appearance of the abscess.
  • Stiff neck (torticollis)
  • Hoarse voice
  • Headache
  • Drooling
  • Swollen lymph nodes on the same side as the location of the abscess

When to see a doctor

Immediately consult a doctor if the above symptoms appear. Examination and immediate treatment in the emergency room also need to be done if the symptoms of a peritonsillar abscess are accompanied by the following conditions:

  • Weak
  • Difficulty breathing
  • Can't eat or drink
  • The saliva that comes out is very much

Diagnosis of peritonsillar abscess

To diagnose a peritonsillar abscess, the doctor will ask questions and get answers about the patient's symptoms and medical 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 immediately diagnose a peritonsillar abscess by looking at the condition of the patient's throat and tonsils. However, to be sure, the doctor can carry out supporting examinations, which include:

  • Blood tests are needed to detect signs of infection.
  • Oral endoscopy is used to see the condition of the oral cavity and the surrounding area using a tool in the form of a camera tube.
  • CT scan of the head or neck to get a clearer picture of the abscess location and ensure there is no respiratory tract obstruction.

Peritonsillar Abscess Treatment

Patients with peritonsillar abscesses need to be treated in the hospital because the pain medications and antibiotics used are often given through an infusion. This is because most patients with peritonsillar abscesses cannot take medication due to trismus or difficulty opening their mouth. 

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

If a peritonsillar abscess causes an obstruction in the airways, the doctor can make a hole in the windpipe (a tracheostomy) for oxygen administration. 

If the patient's condition is stable, the doctor can perform several treatments, such as:

1. Abscess surgery

This action is performed to suck up 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 that is aspirated from the abscess can be taken by the doctor to be sent to the laboratory. Next, a culture test will be carried out to determine the right antibiotic drug.

2. Surgical removal of the tonsils

Surgical removal of the tonsils, or tonsillectomy, can be performed if minor surgery is not effective in dealing with peritonsillar abscesses. In addition, this surgical procedure is also recommended for patients who have recurrent tonsillitis or have had recurrent peritonsillar abscesses. 

3. Painkillers and antibiotics

Pain medication is 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 abscesses. 

Peritonsillar abscess complications

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

  • Respiratory obstruction
  • Dehydration because it's hard to eat and drink
  • Cellulitis of the neck, jaw, or chest
  • Pneumonia
  • Sepsis
If the peritonsillar abscess is caused by group A Streptococcus bacteria, the complications that can occur are:

  • Rheumatic heart disease
  • Rheumatic fever
  • Inflammation of the kidneys (glomerulonephritis)

Prevention of Peritonsillar Abscess

There are several things you can do to reduce the risk of developing a peritonsillar abscess, including:

  • Maintain oral health by regularly brushing your teeth and gargling.
  • Do not smoke.
  • Undergoing treatment and taking antibiotics until they run out according to your doctor's recommendations if you have inflammation of the tonsils
  • Wash your hands frequently and don't touch the nose and mouth area with unwashed hands, so you don't get strep throat easily.

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