Tonsillitis causing an abscess around the tonsils

The article was consulted with Specialist Doctor Ear - Nose - Throat Doctor - Department of Medical Examination & Internal Medicine - Vinmec Ha Long International Hospital.

A tonsil abscess is a purulent inflammatory condition that occurs in the loose connective tissue located around the tonsils, between the tonsils and the side wall of the throat. Abscesses around the tonsils are common in older children and adults. There are many causes of tonsillitis, of which the most common is the resulting tonsillitis.

The tonsils are a lymphatic organization located at the gateway of the respiratory tract and gastrointestinal tract, responsible for protecting the respiratory tract, especially the upper respiratory tract. The lymphatic organization of the tonsils contains mature lymphocytes, such as phagocytes, T lymphocytes and B lymphocytes involved in the production of immunoglobulins.
Therefore, tonsils have the function of protecting the respiratory tract. Therefore, when the tonsils are inflamed, it is necessary to actively treat them to return them to a normal state and perform the body's protective function.
The most common cause of abscess around the tonsils is untreated acute tonsillitis, high bacterial toxins or bacteria that have become resistant to the antibiotics you are taking.

Bacteria causing peritonsillar abscess will be identified when pus from the abscess is cultured. Pathogenic bacteria in tonsil abscess are usually staphylococcus, streptococcus, spirochetes, anaerobic and aerobic bacteria, including group A beta-hemolytic streptococcus. Tonsillitis often occurs during the transition of seasons. , leading to an increase in abscesses around the tonsils when the weather changes.
Tonsillitis is the leading disease in throat diseases, the rate of tonsillitis accounts for about 10% of the population. This disease can present acutely or chronically, but this is a very recurrent disease and can cause dangerous complications, especially in acute episodes, in which abscess around the tonsils is one of the most common symptoms. that complication.
There are many types of bacteria that can cause purulent tonsillitis such as H. influenzae, staphylococcus, pneumococcus, spirochete Vang (Vincent), especially group A streptococcus (St. pyogenes). This is a dangerous bacteria, because from pharyngitis, tonsillitis, they also cause autoimmune disease that seriously damages the glomeruli, joint capsule and heart valves (progressive rheumatic disease) which is very dangerous.
Tonsillitis is often caused by poor hygiene of the throat, mouth, teeth or lazy, unhygienic, especially in some rural and mountainous areas. Meanwhile, there are always some bacteria standing in the upper respiratory tract such as staphylococcus, streptococcus, pneumococcus, H. influenzae....
In addition, polluted environment, dust, smoking or inhalation smoke regularly, especially people with poor resistance such as rickets, malnourished children, elderly people with weak health. Especially when the weather changes suddenly, such as rain, cold, tropical depression or when the northeast monsoon comes, acute tonsillitis is easy to appear and people with chronic tonsillitis are easy to relapse, which can cause Abscess around the tonsils if not treated definitively in the first place.
Abscess around the tonsils can also be a complication of an infected lower wisdom tooth, then spread to the tonsils, causing inflammation, and then leading to an abscess around the tonsils.

Tonsillitis usually appears 5-7 days after acute tonsillitis. If you have a persistent sore throat while you are still on antibiotic treatment, the pain level down in the first day or two of treatment, then increases again and again, you may think of a perianal tonsil abscess.
Sore throat in abscess around tonsils is characterized by pain spreading to the ear when swallowing, pain in the corner of the jaw. Accompanied by high fever from 39-40oC, feeling cold, very tired, dry lips, thick tongue with many opaque white pseudomembranous on the tongue surface. After that, you begin to feel difficulty swallowing, painful swallowing, saliva flow more, bad breath, voice changes, difficulty hearing due to narrow throat.

In the late stage, when the abscess spreads to the bite muscle area, it will cause jaw tightness. You may have difficulty breathing as the abscess fills your oropharynx and spreads down the larynx.
When examining the doctor, the tonsils will be swollen, red, white pus on the surface of the tonsils but easy to remove. The anterior part of the tonsils is swollen and swollen, the tonsils are pushed inward and backward or pushed forward depending on the type of tonsil abscess. Vulvar edema, poor mobility.
Tonsillitis is usually unilateral. The lymph node on the same side as the affected tonsil is also swollen and painful due to the inflammatory reaction spreading to the lymph node. A blood test will show an elevated neutrophil count in peritonsillar abscess.

There is an intermediate stage between acute tonsillitis and peritonsillar abscess, which is inflammation of the tonsils. Detecting the disease in this stage is very important, avoiding the need for intervention, and shortening the treatment time.
In the period of inflammation around the tonsils, it is only necessary to use antibiotics in combination with high-dose oral or injected anti-inflammatory drugs and reduce fever when high fever, good pain relief in about a week.
Once an abscess has formed around the tonsils, the treatment will be more complicated. The doctor will have to use a needle to poke the most bulge on the front of the tonsil to see if there is any pus. This is a procedure for diagnosis and treatment. The pus removed will be cultured for bacteria and made an antibiotic chart to find the most suitable antibiotic for effective treatment.
If it has become an abscess around the tonsils, the extraction of the abscess and drainage of the pus is mandatory, the incision needs to be kept open for about 3 days. Along with that, it is necessary to treat with medical treatment with intravenous or oral antibiotics in combination with antibiogram to fight both aerobic and anaerobic bacteria.
Combination of antipyretic drugs for high fever, pain relievers and anti-inflammatory drugs. Treatment time for peritonsillar abscess usually lasts at least 10 days. Patients are usually indicated for tonsillectomy after the end of local and systemic inflammatory signs about 1 month.
Tonsillitis if not diagnosed and treated promptly can cause complications such as diffuse inflammation of the posterior visceral space, abscess spreading to mediastinum, lung, bacteremia... can even cause death, therefore very dangerous.

When symptoms of acute or chronic tonsillitis appear, you need to perform treatment according to the instructions of an otolaryngologist. You should not arbitrarily buy medicine for treatment or use the wrong medicine, how to use it, and when to take it as prescribed by your doctor.
Keep your throat clean regularly by gargling daily from a mild alkaline solution, eating hygienically, paying attention to keeping your body warm when it's cold.
It is necessary to wear a mask when going out to avoid dust because in the dust there are countless pathogenic microorganisms, not to mention toxic substances for the respiratory tract, especially in areas with polluted air. Do not smoke cigarettes, pipe tobacco directly or indirectly.
In summary, tonsil abscess is a purulent inflammatory condition that occurs in the loose connective tissue located around the tonsils, between the tonsils and the side wall of the pharynx. Abscess around the tonsils can affect the health and life of the patient if not treated promptly. Therefore, when there are signs of tonsillitis, the patient should go to a medical facility for proper diagnosis and treatment.
Vinmec International General Hospital is the address for examination and treatment of common ENT diseases, tumors of the head, face, and neck, congenital malformations of the ear, nose and throat area with the best internal - surgical methods. best for patients, both children and adults. Coming to Vinmec International General Hospital, patients will receive a direct, dedicated and professional examination from a team of qualified and experienced medical staff.