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Symptoms and Signs of Peritonsillar Abscess

Doctor's Notes on Peritonsillar Abscess

A peritonsillar abscess is a collection of pus that forms in the tissues of the throat next to one of the tonsils. When the tonsils become infected (tonsillitis) and the infections spreads to the soft tissues, a peritonsillar abscess may result.

The first symptom of a peritonsillar abscess is typically a sore throat that is isolated on one side. Once the sore throat starts, it can take 2-5 days for the abscess to form. Swelling of the mouth and throat (typically on one side) may occur, the uvula may be pushed away from the swollen side, and the lymph glands in the neck may be enlarged and tender. Other signs and symptoms of a peritonsillar abscess include painful swallowing, fever and chills, muscle spasm in the muscles of the jaw (trismus) and neck (torticollis), ear pain on the same side as the abscess, a muffled voice, and difficulty swallowing saliva.

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019

Peritonsillar Abscess Symptoms

The first symptom of peritonsillar abscess is usually a sore throat. A period without fever or other symptoms may follow as the abscess develops. It is not unusual for a delay of 2-5 days between the start of symptoms and abscess formation.

  • The mouth and throat may show a swollen area of inflammation - typically on one side.
  • The uvula (the small finger of tissue that hangs down in the middle of the throat) may be pushed away from the swollen side of the mouth.
  • Lymph glands in the neck may be enlarged and tender.
  • Other signs and symptoms may be observed:
    • Severe sore throat that becomes isolated to one side
    • Painful swallowing
    • Fever and chills
    • Muscle spasm in the muscles of the jaw (trismus) and neck (torticollis)
    • Ear pain on the same side as the abscess
    • A muffled voice, often described as a "hot potato" voice (sounds as if you have a mouthful of hot potato when you talk)
    • Difficulty swallowing saliva

Peritonsillar Abscess Causes

A peritonsillar abscess is most often a complication of tonsillitis. The bacteria involved are similar to those that cause strep throat.

Streptococcal bacteria most commonly cause an infection in the soft tissue around the tonsils (usually just on one side). The tissue is then invaded by anaerobes (bacteria that can live without oxygen), which enter through nearby glands.

Top Problems in Your Mouth Slideshow

Top Problems in Your Mouth Slideshow

Also called fever blisters, you don't get cold sores from fevers or colds but they can be triggered by them. The virus that causes cold sores is usually passed via a kiss, shared utensils, or other close contact. Over-the-counter creams and ointments may help discomfort and speed healing. Frequent sores may require a prescription. Cold sores are a top mouth problem. Other problems include canker sores, TMJ, bad breath, and mouth cancer.


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.