Peritonsillar Abscess

Peritonsillar Abscess:
Peritonsillar Abscess (PTA) is a common deep infection or head and neck caused by colonization of Aerobic and Anaerobic bacteria in the Peritonsillar space in head and neck region.

Although it is not confirmed how this disease/infection starts and how it spreads, there are a couple of theories which explains the possible conditions in which a person may get infected. The infection is believed to start from the region between palatine tonsil and its capsules at the superior pole end. The first theory about the initiation of the infection is believed to be because of acute tonsillitis where as few believe that the pus formation and necrosis of the capsules leads to the infection.

What are symptoms of PTA?
People infected with PTA experiences the following symptoms:
1) Soared throat, fever & chills accompanied by timely neck pain sessions.
2) Patient may experience sudden change in his/her voice
3) Dysphagia
4) Malaise
5) Odynophagia
6) Patient also may experience dehydration
7) Difficulty in swallowing anything, opening mouth, any type of secretion and drooling.
8) Tonsillar hypertrophy (asymmetric)
9) Tonsils may get displaced from their normal position
10) Complexities related to tonsils may erupt in the patient for example exudates on the tonsil and erythema of tonsils. Etc.

Who is at the risk of developing PTA?
As mentioned earlier, the infection ratio in male and female for PTA is almost same. People suffering from the infections of peritonsillar area are prone to PTA. Also, those people whose immune system is weak/damaged are more prone to PTA.

Causes of PTA:
As already mentioned above, aerobic (mainly Streptococcus subtypes/species) and anaerobic (mainly Peptostreptococci and Prevotella subtypes/species) bacteria play an important role in PTA infection.
It is said to develop due to the complications in tonsillitis and formation of pus around the tonsils (known as peritonsillar area).

Diagnosis and treatment available for PTA:
If the patient is suspected to have developed PTA, doctor may prefer to carry out some tests in order to confirm the PTA infection in the patient. Doctor may prefer some tests like monospot test (also known as heterophile antibody), fluid culture aspiration, radiography, CT scan, ultrasonography etc.
Once the patient is diagnosed, doctor may start treatment to first of all give relief to patient (such as clearing patient’s airways) so that the treatment can be extended further to remove the abscess. Due to the involvement of complications such as dehydration, fever etc., it becomes important to treat the patients for such problems (for example fluid resuscitation for dehydration and treatment for fever). Doctor may take help of antibiotics in order to avoid further complications and spread of pus. Drainage (one of the two most commonly used techniques to cure PTA) of the abscess is also very important; your doctor may use latest available technique in order to get rid of pus. The other most commonly used technique is incision, but care should be taken in order to avoid complications associated with it. The patient might also be given steroids or pain-killers to minimize pain.
Based on the patient’s condition and other options, doctor may chose tonsillectomy, which has proved to be a subject of argument among many specialists due to issues such bleeding, cost etc. associated with it.

Complications associated with PTA:
PTA, if not taken care of properly or treatment is delayed, may lead to medical complications such as:
1) The infection might return in the patient later in life
2) The infection may lead to Necrotizing infection of soft tissues in and around the Neck area.
3) Patient may develop aspirations which may later lead to pneumonitis or pneumonia.
4) Patient also may develop medical complications such as Mediastinitis, Meningitis, jugular vein thrombosis, necrosis or rupture of carotid artery, and Sepsis etc.

Prevention:
As the actual cause of PTA infection has not yet been confirmed, there is no proven preventive measurement available for PTA infection. However, its important to keep in mind the following points in order to keep a distance from possible infection of PTA:
If you are experiencing problem of developing tonsillitis frequently, frequent throat infections of any type, then you should be careful about getting yourself checked for possible infection of PTA. Try to avoid eating food that can facilitate pus formation in internal organs. Avoid smoking as it causes many complications along with being injurious to health.