Peritonsillar Abscess (cont.)
Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
The doctor's primary concern will be your breathing and airway. If your life is in danger because your throat is blocked, the first step may be to insert a needle in the pus pocket and drain away enough fluid so you can breathe comfortably.
If your life is not in immediate danger, the doctor will make every effort to keep the procedure as painless as possible. You will receive a local anesthetic (like at the dentist) injected into the skin over the abscess and, if necessary, pain medicine and sedation through an IV inserted in your arm. The doctor will use suction to help you avoid swallowing pus and blood.
- The doctor has several options for treating you:
- Needle aspiration involves slowly putting a needle into the abscess and withdrawing the pus into a syringe.
- Incision and drainage involves using a scalpel to make a small cut in the abscess so pus can drain.
- Acute tonsillectomy (having a surgeon remove your tonsils) may be needed if, for some reason, you cannot tolerate a drainage procedure, or if you have a history of frequent tonsillitis.
- You will receive an antibiotic. The first dose may be given through an IV. Penicillin is the best drug for this type of infection, but if you are allergic, tell the doctor so another antibiotic can be used (other choices may be erythromycin or clindamycin).
- If you are healthy and the abscess drains well, you can go home. If you are very ill, cannot swallow, or have complicating medical problems (such as diabetes), you may be admitted to the hospital. Young children, who often need general anesthesia for drainage, frequently require a hospital stay for observation.
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