Peritonsillar Abscess

Medically reviewed by Drugs.com. Last updated on May 6, 2024.

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What is a peritonsillar abscess (PTA)?

A PTA is a collection of pus in the peritonsillar space. The peritonsillar space is the area between your tonsil and the back wall of your throat. It is near the opening of the tubes leading to your stomach and lungs.

What increases my risk for a PTA?

A PTA is caused by bacteria. The following may increase your risk for a PTA:

• Infection of your tonsils that spreads to the tissues around it
• A mouth infection, such as a tooth or salivary gland infection
• Cigarette use

What are the signs and symptoms of a PTA?

• A sore throat that is usually on 1 side and may be severe
• Ear pain on the same side as the sore throat
• Drooling, bad breath, or a muffled voice
• Fever, body aches, or a headache
• Loss of appetite, nausea, or constipation
• Red and swollen tonsil or throat
• Pain or difficulty when you open or close your mouth, swallow, and move your neck

How is a PTA diagnosed?

Your healthcare provider will examine your mouth and throat. Your provider will look to see how red or swollen your abscess is or check to see if it is draining. You may need any of the following:

• Blood tests may show infection or to give information about your overall health.
• Needle aspiration may show what is causing your abscess. A needle will be used to take the fluid out of the abscess. The fluid is sent to a lab for tests.
• An x-ray, CT scan, MRI, or ultrasound may show the peritonsillar abscess. You may be given contrast liquid to help the abscess show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious damage. Tell the provider if you have any metal in or on your body.

How is a PTA treated?

• Antibiotics help treat or prevent a bacterial infection.
• Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly.
• NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask if NSAIDs are safe for you. Always read the medicine label and follow directions. Do not give these medicines to children younger than 6 months without direction from a healthcare provider.
• Steroids decrease swelling.
• Incision and drainage may be needed to drain your peritonsillar abscess. Your healthcare provider will make a cut in the abscess to allow the pus to drain.
• Surgery may be needed if other treatments do not work or your PTA happens again. Surgery may be done to remove your abscess completely. This may include removal of your tonsils.

What can I do to manage my symptoms?

• Eat foods that are easy to swallow. Your healthcare provider may recommend a soft diet. A soft diet includes moist foods that may be ground, mashed, or pureed.
• Drink liquids as directed. Try to drink liquids throughout the day. Liquids will help prevent dehydration.
• Gargle salt water, if directed. Mix ¼ teaspoon salt in an 8 ounce glass of warm water and gargle. Do not swallow. Salt water may help decrease swelling in your throat. Your provider will tell you how often to do this each day, and for how many days to continue.

What can I do to prevent a PTA?

• Care for your mouth and teeth. Brush and floss your teeth after you eat, and before you go to sleep. Gently brush your teeth and gums using a brush with soft bristles. Use a mouth rinse after you brush. See your dentist for regular check-ups.
• Do not delay treatment for a sore throat. Make an appointment to see your doctor if you have a sore throat that continues for more than a few days. If you have a fever with a sore throat, call your doctor that day. Early treatment may prevent a peritonsillar abscess. Take your antibiotic for throat infections until it is done.
• Do not smoke. Nicotine and other chemicals in cigarettes and cigars may increase your risk for a peritonsillar abscess. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

Call your local emergency number (911 in the US) if:

• You have trouble breathing.

When should I seek immediate care?

• You have a stiff neck.
• You have bleeding in your throat.
• You have more pain, swelling, or redness in your throat.
• Your symptoms get worse or do not get better, even with treatment.
• You have more trouble opening your mouth or pain when you swallow.
• You cannot eat or drink because of your symptoms.

When should I call my doctor?

• You have a new or worsening fever.
• Your abscess returns.
• You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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