peritonsillar abscess

Peritonsillar Abscess

Peritonsillar abscess is also called quinsy or PTA is collection of pus and purulent exudates between tonsillar capsule and surrounding tissue.

Peritonsillar abscess is complication of tonsillitis.

Etiology

1. Streptococcal bacteria

2. Dental infection, periodontitis, gingivitis

3. Chronic tonsillitis

4. Stone and calcium deposit in tonsils (tonsilloliths)

5. CLL (Chronic lymphocytic leukemia)

Pathophysiology

Peritonsillar abscesses are caused by mostly same bacteria that cause strep throat. 

Peritonsillar abscess usually occurs due to complication of tonsillitis.

 If the tonsil infection infiltrate deep tissue and breaks out of a tonsil and gets into the space around tonsillar capsule  can result tissue necrosis and formation of abscess .if progress involved soft tissue surrounding area. 

Clinical Manifestations

1. Sore throat

2. Inflammation of one side throat

3. Swelling of soft palate

4. Lymph node of neck swollen and tender

5. Deviation of uvula

6. Difficulty in swallowing; Dysphagia

7. Painful swallowing; Odynophagia 

8. Muscle spasm in muscle of jaw and neck

9. Otalgia on same side of abscess

10. Trismus; inability or difficulty in opening of mouth

11. Hot potato voice

Diagnostic Evaluation

1. Physical examination

Tenderness, difficulty/pain in swallowing, muscle spasm of jaw, hot potato voice

2. Needle aspiration 

3. CT scan 

Management

1. Antibiotics

2. Antipyretic and analgesic

3. Assess patient airways

4. Fluid resuscitation

Surgical Management

1. Needle aspiration

2. Incision and drainage

3. Tonsillectomy

Nursing Diagnosis

1. Acute pain

2. Risk of infection

3. Nutrition deficiency less than body requirement

4. Fluid volume definitely

5. Anxiety

6. Activity intolerance