Peritonsillar Abscess

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KEY POINTS

• A peritonsillar abscess is a collection of pus around the tonsils and in the throat. Pus is a thick fluid that usually contains white blood cells, dead tissue, and germs.
• Treatment may include antibiotic medicine and a procedure to drain the abscess.
• Ask your child’s healthcare provider how long it will take to recover and how to take care of your child at home.

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What is a peritonsillar abscess?

A peritonsillar abscess is a collection of pus around the tonsils and in the throat. Pus is a thick fluid that usually contains white blood cells, dead tissue, and germs.

Your child has 2 tonsils, one on each side of the back of the throat. They are small reddish, oval-shaped masses and are easy to see. They help fight nose and throat infections.

What is the cause?

A peritonsillar abscess is usually an infection. Your child may get a peritonsillar abscess after being sick with:

• Tonsillitis, which is an infection in the tonsils usually caused by bacteria or a virus
• Strep throat

What are the symptoms?

Sore throat is a common symptom that can be just scratchiness or can be intense pain.

Signs and symptoms may include:

• A raw feeling in your child’s throat that causes pain when breathing, swallowing, or talking
• Redness of the throat
• Fever and chills
• Hoarseness
• Pain or trouble swallowing because of swollen tonsils
• Drooling
• Pus in your child’s throat
• Tender, swollen glands in your child’s neck
• Earache (your child may feel pain in the ears even though the problem is in the throat)

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and medical history and examine your child. Tests may include:

• A throat swab to test for a strep infection
• Blood tests
• Ultrasound, which uses sound waves to show pictures of the throat
• CT scan, which uses X-rays and a computer to show detailed pictures of the throat

How is it treated?

Treatment may include:

• Antibiotic medicine
• Needle drainage. Your child’s healthcare provider will remove the fluid and pus from the abscess with a needle. Your child will have medicine so he or she won’t feel pain.
• Incision and drainage. Your child’s healthcare provider will make a cut into the tissue and drain the infection. Your child’s provider will leave the area open to drain, and it will heal as the infection clears up. Your child will have medicine so he or she won’t feel pain.
• Tonsillectomy, which is surgery to remove the tonsils

How can I take care of my child?

Follow the full course of treatment prescribed by your child’s healthcare provider. In addition:

• Help your child take the antibiotics for as long as your child’ healthcare provider prescribes, even if your child feels better. If your child stops taking the medicine too soon, it may not kill all of the bacteria and your child may get sick again. If your child has side effects from the medicine, talk to your child’s healthcare provider.
• Give your child nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen to treat pain or fever. Read the label carefully and give your child the correct dose as directed.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems.
  • Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye’s syndrome.
  • Acetaminophen may cause liver damage or other problems. Do not give more doses than directed. To make sure you don’t give your child too much, check other medicines your child takes to see if they also contain acetaminophen. Unless recommended by your healthcare provider, your child should not take this medicine for more than 5 days.
• Advise your child not to smoke and to stay away from others who are smoking.
• Have your child get plenty of rest.
• Your child may want to rest his or her throat by talking less and eating a diet that is mostly liquid or soft for a day or two. Your child should avoid salty or spicy foods and citrus fruits. Your child should drink extra fluids, such as water, fruit juice, and tea.
• Use a humidifier to put more moisture in the air. Avoid steam vaporizers because they can cause burns. Be sure to keep the humidifier clean, as recommended in the manufacturer's instructions. It's important to keep bacteria and mold from growing in the water container.
• Cough drops may help relieve the soreness.
• Gargling with warm saltwater may help. You can make a saltwater solution by adding 1/4 teaspoon of salt to 8 ounces, or 240 mL, of warm water.

Ask your child’s healthcare provider:

• How and when you will get your child’s test results
• How long it will take to recover
• If there are activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

How can I prevent a peritonsillar abscess?

The following suggestions may help prevent a peritonsillar abscess:

Help your child have good dental hygiene. Follow your child’s dentist’s instructions for cleaning and flossing your child’s teeth.

Help or teach your child to:

• Wash hands for at least 20 seconds often and especially after using the restroom, coughing, sneezing, or nose blowing. Also help him wash his or her hands before eating or touching the eyes.
• Stay at least 6 feet away from people who are sick, as much as possible.
• Stay indoors as much as possible on high-pollution days.
• Take care of your child’s health. Make sure your child eats a healthy diet and gets enough sleep and exercise every day. Teach your child to avoid alcohol, caffeine, nicotine, and drugs. Help your child learn ways to manage stress.