What is this Condition?
A throat abscess is a localized accumulation of pus that may occur around the tonsils or in the back of the pharynx. With treatment, the prognosis for a person with throat abscess is good.
What Causes it?
Abscess around the tonsils is a complication of acute tonsillitis, usually after streptococcal or staphylococcal infection. It occurs more often in adolescents and young adults than in children.
Acute abscess in the back of the pharynx is caused by infection in the lymph glands, which may follow an upper respiratory bacterial infection. Because these lymph glands, present at birth, start to become smaller after age 2, this condition most commonly affects infants and children under age 2.
Chronic abscesses in the back of the throat may result from tuberculosis of the cervical spine and may occur at any age.
What are its Symptoms?
The person with an abscess around the tonsils will have severe throat pain, occasional ear pain on the same side as the abscess, and tenderness of the submandibular gland. Difficulty swallowing causes drooling. Tightening of the jaw muscles may occur as a result of swelling and spreading of the infection. Other symptoms include fever, chills, malaise, rancid breath, nausea, muffled speech, and dehydration.
The person with an abscess in the back of the pharynx will have pain, difficulty swallowing, and fever. When the abscess is located in the upper pharynx, the person may develop nasal obstruction. When the abscess is located in the lower pharynx, the person may develop difficult and noisy breathing. Children may experience drooling and muffled crying. A very large abscess may press on the larynx, causing swelling, or may erode into major vessels, causing sudden death from asphyxia or aspiration.
How is it Diagnosed?
The doctor bases the diagnosis on the person’s health history and on a throat exam. A person with an abscess around the tonsils commonly has a history of bacterial pharyngitis. A lab culture may reveal streptococcal or staphylococcal infection.
A person with an abscess in the back of the pharynx commonly has a history of nasopharyngitis or pharyngitis. The doctor will also take X-rays of the larynx and may order culture and sensitivity tests to isolate the causative organism and determine the appropriate antibiotic treatment.
How is it Treated?
If an abscess around the tonsils is caught early, treatment consists of large doses of penicillin or another antibiotic. For late-stage abscess, primary treatment is usually incision and drainage under local anesthesia, followed by antibiotic therapy for 7 to 10 days. Tonsillectomy, scheduled no sooner than 1 month after healing, prevents recurrence but is recommended only after several episodes.
If a person has an acute abscess in the back of the pharynx, the doctor will make an incision to drain the abscess through the pharyngeal wall. In chronic conditions, drainage is performed through an external incision behind the adjacent neck muscles. Postoperative drug therapy includes antibiotics (usually penicillin) and analgesics.
What can a person with a throat abscess do?
After incision and drainage, the doctor may prescribe antibiotics, pain relievers, and fever-reducing medications. Be sure to complete the full course of prescribed antibiotic therapy. To promote healing, use warm salt water gargles or throat irrigations for 24 to 36 hours. Get adequate rest