From the Guidelines
A peritonsillar abscess typically presents with severe sore throat, difficulty swallowing, muffled voice, fever, and general malaise, and requires prompt medical attention to prevent complications such as airway obstruction or spread of infection to deeper tissues. The symptoms of a peritonsillar abscess can be identified as:
- Severe sore throat that is typically worse on one side
- Difficulty swallowing or painful swallowing (odynophagia)
- Muffled or "hot potato" voice
- Fever
- General malaise
- Trismus (difficulty opening the mouth) due to inflammation of nearby muscles
- Asymmetric swelling of one tonsil with displacement of the uvula to the opposite side
- A collection of pus between the tonsil and its surrounding tissue
- Ear pain on the affected side
- Drooling due to difficulty swallowing saliva
- Bad breath
- Swollen lymph nodes in the neck These symptoms develop as bacteria, commonly streptococcal species, create an infection that progresses from tonsillitis to form a collection of pus in the peritonsillar space 1. It is essential to note that while the provided evidence focuses on the diagnosis and management of group A streptococcal pharyngitis, the symptoms of peritonsillar abscess are a complication of this condition, highlighting the importance of accurate diagnosis and appropriate antimicrobial therapy to prevent such complications 1.
From the Research
Symptoms of Peritonsillar Abscess
- Fever 2, 3
- Sore throat 2, 3
- Dysphagia (difficulty swallowing) 2
- Trismus (lockjaw) 2, 3, 4
- "Hot potato" voice 2
- Throat pain 3
- Unilateral peritonsillar swelling 4
Diagnosis and Treatment
- Diagnosis is usually made on the basis of clinical presentation and examination 2
- Needle aspiration is the gold standard for diagnosis and treatment of peritonsillar abscess 3
- Antibiotic therapy, including penicillin, clindamycin, cephalosporins, or metronidazole, is effective against group A streptococcus and oral anaerobes 2, 3
- Amoxicillin-clavulanic acid is suggested as the first drug of choice for patients presenting with unilateral peritonsillar swelling and trismus 4
- Intramuscular clindamycin is an excellent choice and can be safely prescribed on an outpatient basis following needle aspiration 5