Paratonseal abscess - causes, symptoms and treatment

Paratonsillary abscess is a collection of pus in the tissues of the throat, next to one of the tonsils. The development of this disease occurs as a result of the penetration of infectious pathogens (streptococci, staphylococci and others) into the amygdala. Often, peritonsillar abscess occurs as one of the complications of chronic tonsillitis or tonsillitis.

This lesion is relatively common among adults, and is very rare in infants and children. In mild cases, an abscess can cause pain and swelling of the tissues, and in severe cases it can block the throat. In such cases, there is difficulty swallowing, speech and even breathing.

What is dangerous paratonsillar abscess?

This disease is extremely dangerous because of the high probability of pus entering the deeper tissues of the neck. As a result, phlegmon (purulent inflammation of the soft tissues of the neck), mediastinitis (inflammation of the chest cavity tissues), sepsis (infection of the blood), acute stenosis of the larynx (narrowing of the lumen of the larynx and choking) may develop; risk of death is not excluded. All these consequences are a good reason for hospitalization of patients.

The reasons

Why does paratonsillar abscess occur, and what is it? The main causative agents of paratonzillitis and paratonsillar abscess are group A Streptococcus pyogenes and Staphylococcus aureus; Anaerobic microorganisms are also important. In addition, paratonsillar abscess may have a polymicrobial etiology.

Paratonsillitis and paratonsillar abscess develops in the case of the penetration of the pathogen from the crypts of the affected palatine tonsil through its capsule into the surrounding paratonsillar tissue and intermuscular spaces. As a result, an infiltrate is formed, which, in the absence of adequate therapy, passes into a stage of purulent fusion and a paratonsillar abscess is formed (see photo).

Usually it takes several days after a sore throat, the patient may even feel some relief, but then again suddenly the body temperature rises to quite high numbers (38-39) degrees Celsius, he feels a sharp pain in his throat when swallowing. Often the pain is localized on one side only. In the future, there are two possible outcomes of the situation, or this inflammation goes away independently under the influence of treatment, or in 3-4 days the so-called paratonsillar abscess is formed.


There are three types of paratonsillar abscess, each of which has its own distinctive features:

  1. Anterior-upper - occurs in 90% of cases. This is due to poor outflow of pus from the upper pole of the amygdala, which leads to its accumulation and further spread to the fiber.
  2. Rear - detected in every tenth sick. It can be complicated by laryngeal edema and, as a result, respiratory failure.
  3. Bottom - is quite rare. Its development is associated, as a rule, with odontogenic cause. The abscess is located in the tissue behind the lower third of the palatine arch between the palatal and lingual tonsils.

Symptoms of peritonsillar abscess

In the event of a paratonsillar abscess, the symptoms are very similar to the manifestations of a sore throat. The first warning sign is a severe sore throat. However, when opening the mouth, we see a swollen throat with changes similar to sores.

Symptoms of paratonsillar abscess most often develop in the following sequence:

  • body temperature rises sharply to 38-39 ° C;
  • difficulty swallowing;
  • sore throat, as a rule, one-sided (but bilateral abscess development is not excluded);
  • when swallowing, pain can be given to the ear, teeth, or the back of the head on the side that has a sore throat;
  • pain increases dramatically when you try to open your mouth;
  • it is impossible to fully open the mouth due to spasms of the masticatory muscles;
  • weakness, muscle pain;
  • the condition of the patient in the absence of treatment is rapidly deteriorating, there are signs of microbial intoxication: headache,
  • nausea, dizziness, diarrhea;
  • swollen lymph nodes under the lower jaw, at the back of the head.

Paratonsillar abscess, if not treated, can lead to very serious consequences - difficulty breathing, infection of neighboring organs, pneumonia. Therefore, if you see signs that indicate an abscess, you should urgently take action.

Paratonsillar abscess: photo

What this disease looks like, we offer to view detailed photos.


Typically, the paratonsillar abscess ends in recovery, however, with the high virulence of the pathogenic flora and weakening of the body’s defenses, a terrible complication such as phlegmon of the parapharyngeal space may develop, with such disorders:

  • intoxication of the body;
  • the patient is experiencing severe salivation;
  • difficulty opening the mouth;
  • high body temperature;
  • the patient becomes difficult to breathe, and he practically can not swallow.

Particularly dangerous is the transition of cellulitis into purulent mediastinitis, which leads to the following consequences of paratonsillar abscess:

  • thrombophlebitis;
  • bleeding of the cervical vessels;
  • septic processes;
  • infectious toxic shock;
  • tissue necrosis.

How to treat paratonsillar abscess

It should be understood that paratonsillar abscess cannot be cured at home. All funds used to treat angina are ineffective. Even if the abscess has ripened and it seemed to you that pus flowed out, this is far from being the case. Most of the pathological purulent contents remained in the depth of the soft tissues. Over time, the pathological microflora will contribute to the formation of purulent masses. Pus in the abscess will accumulate until it reaches a critical mass and its re-outflow occurs.

Depending on the symptoms, the paratonsillar abscess treatment is carried out by three main methods:

  1. Combined therapy is the most effective treatment method, which is based on a competent combination of different treatment methods.
  2. Conservative therapy - the use of drugs of local and general action, physiotherapy. Effective in the early detection of inflammatory disease of the tonsils.
  3. Surgical treatment - is a radical method of treatment, which involves the removal of damaged tissue.

If treatment of peritonsillar abscess is started promptly, the prognosis of the outcome of the disease is favorable. Otherwise, the development of more serious complications, including sepsis, is possible. Traditional medicine is also widely used in the treatment of abscess: tonsils rinse decoction of chamomile, eucalyptus, make steam inhalation. You must also follow the diet. The patient is recommended to eat warm and liquid food.


The basis for the prevention of the disease is a timely visit to the doctor, treatment of foci of chronic infection, rehabilitation of the oral and nasal cavities, strengthening the immune system, hardening, nutrition and sports. Early diagnosis and timely treatment give a chance for a complete and rapid recovery.


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