When we get a sore throat, but there is always the possibility of complications. Even if it is a banal tonsillitis that worries us after hypothermia or excessive eating of ice cream. One of the most common comorbidities is paratonsillar abscess. Symptoms of a paratonsillar abscess are swelling of the neck, high fever, and foreign body sensation. All of them are also found in ordinary angina, so it is difficult to immediately recognize an additional disease. Patients try to the last to be treated at home, but after the temperature rises to 40 degrees, they still seek help from a doctor.
The essence of pathology
Abscess in medicine is called inflammation of the soft tissues, accompanied by the formation of pus. In fact, this is an accumulation of purulent detritus under the skin, mucous membranes or inside fascial cases. If the process spreads over large areas, then it is already classified as a phlegmon. This pathology provokes the reproduction of bacteria or fungi.
Despite the fact that the symptoms of paratonsillar abscess are quite easily tolerated by a person, this is a disease that can be fatal. The infected fluid melts the tissues it comes in contact with and can enter the brain, neck, and even the chest cavity. This will cause the infection to spread throughout the body, shock and rapid death.
Historical sketch
To fully understand the seriousness of this pathology, you can use examples from history. It is better to start from ancient times. In the twelfth century BC, the Shah of Khorezm, Ala ad-Din Tekesh, died from this pathology. It is difficult to blame this person for ignorance and neglect of symptoms, since it was during his reign that the state reached its greatest cultural and political flourishing.
There is a version that it was from a paratonsillar abscess that the famous leader of the Seminole Indians, Osceola, died. It happened in 1838 when the Spaniards conquered South America. Again, the medicine of these peoples was at a high level, Europeans did not even hear about many medicines. Therefore, there is no need to talk about negligence.
French writer and philosopher Michel Montaigne, Pope Adrian the Fourth and Scottish professor of religious studies Ian MacLaren and some other celebrities have died from a seemingly simple illness.
Views
Since the symptoms of paratonsillar abscess are always typical, it is classified among otorhinolaryngologists solely by location. There are four forms of the disease.
- Top. It is the most common form of purulent process. This is due to the anatomical features of the tonsils. The upper surface of the organ experiences a strong bacterial load, as it is the first to take the blow when contaminated with an inflammatory agent. The disease begins with the appearance of a delicate yellowish coating on the palatine arches.
- Posterior form, when the focus is located between the palatine arch and tonsil. This is the easiest option for diagnosis, since the site of inflammation is clearly visible. The disease causes significant discomfort to the patient, interferes with speaking, swallowing and opening the mouth. In difficult cases, there may be respiratory problems.
- Lower form. Abscess captures only the lower part of the tonsil. This complication is usually caused by diseases of the teeth and gums.
- Outer shape. It is an extremely rare occurrence. In some literature, you can find the name lateral paratonsillar abscess. It is with this localization that the highest probability of infection spreading to neighboring areas.
The disease begins acutely, chronic cases are casuistic and occur only in socially disadvantaged citizens who do not seek medical help immediately.
Etiology
Symptoms of paratonsillar abscess appear when a purulent inflammation develops on the tonsil in neighboring tissues, caused by the reproduction and vital activity of bacteria. Most often, staphylococci and streptococci act as an infectious agent, butit can be fungi, opportunistic bacteria, and sometimes even viruses.
Paratonsillar abscess is not an independent disease. As a rule, this is the result of improper or artisanal treatment of angina. Patients believe that inflammation in the throat is too simple and unpretentious diagnosis to bother the doctor with such trifles. But in fact, you should not neglect your own he alth, and it is better to seek help at the very beginning than to correct the consequences of your inept actions later.
The second reason for abscesses of this localization is chronic tonsillitis. A sluggish infectious process is constantly developing in the body, which poisons a person, makes his immunity weak. All this leads to complications of even the most banal cold.
Sometimes paratonsillitis appears after the removal of lymphoid tissue from the palatine arches. This may be the result of a poor-quality operation, when part of the tonsils still remained and they recovered to their previous size. Or when the doctor damaged the delicate mucous membrane of the larynx with instruments.
Fourth place in the ranking of causes of abscess is caries. This is also a constant focus of infection, which must be sanitized so as not to weaken the body's defenses and not provoke bacteria "on the offensive".
Symptoms
How does paratonsillar abscess develop? Symptoms do not appear immediately, but only three to four days after the invasion of the pathogen into the tonsils. Most clearly, the clinic begins to manifest itself from the fifth day of illness.
The very first symptom is pain. At first, it causes slight discomfort, but in the process of increasing swelling and accumulation of pus, it becomes more and more difficult to endure it. Pain is localized on the same side as the abscess, but can spread to the ear, upper jaw, neck, maxillary sinuses.
A typical symptom of a paratonsillar abscess is swelling of the larynx and the presence of swelling of the mucous membrane on the side of the lesion. The tissues in this place are red, strongly stretched, hot. Because of this “lump”, swallowing, breathing are disturbed, and over time, a lesion of the chewing muscles develops - lockjaw. It becomes difficult for the patient to open his mouth.
Due to the circulation of infection in the human body, the submandibular, occipital and cervical lymph nodes increase. Sometimes it is even noticeable to the naked eye. The patient hardly turns his head, bends his neck, sleeps poorly. Purulent processes give rise to bad breath, and the spread of inflammation to the tissue of the neck can cause hoarseness. Of the general symptoms, a sharp increase in temperature, weakness, and sleep disturbance stand out.
Paratonsillar abscess in children
Not only in adults, paratonsillar abscess can be observed as a complication. Symptoms in children often do not correspond to the severity of intoxication, as their immune system is imperfect and does not always adequately respond to infection.
The sore throat cannot be relieved by any rinses and compresses, the child is not even able to swallow saliva, let alone take medicine or eat. In childrenin infancy, swelling of the throat causes breathing problems until it stops. The second warning sign for parents should be a change in voice. It becomes hoarse and gurgling, as if their child is holding a hot potato in his mouth.
Some children have spasms of the muscles of the face and neck, trismus, pain radiating to the ear or back of the head. On an objective examination, redness is observed not only on the side of the lesion, but throughout the pharynx.
Diagnosis
How to diagnose "peritonsillar abscess"? Its symptoms are bright enough so that this can be done on the basis of one clinical picture. The doctor collects an anamnesis, then asks the patient to open his mouth wide and examines the mucous membrane of the oropharynx and larynx. With a spatula, be sure to touch the place of swelling, remove films from the tonsils.
Then refer the patient for laboratory diagnosis:
- clinical blood test;
- clinical urinalysis;
- bacterial examination of discharge from the pharynx;- sputum culture for diphtheria bacillus.
If necessary, the patient should take an x-ray or tomography of the neck to visualize the area of the pathological process.
Treatment
If you have been diagnosed with a paratonsillar abscess, home treatment is strictly contraindicated. If the patient really does not want to go to the hospital, then he must be in a day hospitalunder the supervision of staff. Treatment of an abscess can be conservative, surgical or complex.
Can pills get rid of paratonsillar abscess. Antibiotic treatment is effective only at the beginning of the disease, when the bacteria have not yet reached a critical mass and spread throughout the body. But even in advanced cases, doctors must prescribe antibacterial agents to prevent sepsis and reduce the effects of intoxication.
Local prescribe rinses with antiseptics ("Chlorophyllipt", "Furacilin", warm hypertonic solutions) and ointments that relieve pain and inflammation.
Folk remedies
Is it possible to treat paratonsillar abscess without surgery? Traditional medicine responds with a categorical refusal. Therapy at home, exclusively by artisanal methods, can become dangerous to life and he alth. But on the other hand, grandmother's recipes will come in handy as an aid against swelling and sore throat.
What does it take to soothe a paratonsillar abscess? Treatment with folk remedies involves the use of honey and bee products. First of all, this applies to propolis, which combines the properties of an antiseptic and an immune stimulant. For rinsing, a tincture of their spruce cones with the addition of coniferous essential oils is well suited.
Opening an abscess
You can't diagnose a paratonsillar abscess from a photo. The symptoms, of course, are very colorful, but doctors love“look with your hands”, therefore, with signs of this ailment, it is recommended to run for a consultation with a surgeon.
The doctor examines the patient, issues a verdict and directs to open the abscess. The whole process takes place in the clinic and takes about 20 minutes. After anesthetizing the inflamed area, the surgeon makes several incisions and collects the pus that has appeared in the tray. Then he inserts a drainage (tube or rubber strip) to improve the outflow of fluid. Sometimes tonsils are also removed along with the opening of the abscess.
Complications
How can a paratonsillar abscess end? Its symptoms and treatment do not cause additional questions among the inhabitants, since everything is logical and understandable. But if you evade therapy, then the pathological process can expand and lead to serious consequences:
- Phlegmon of the neck. Pus melts fatty tissue and flows under the skin of the neck, inflammation increases, an ulcer and necrosis may even appear.
- Mediastinitis. If, with phlegmon of the neck, the patient does not go to the hospital and waits, then the pus moves further and enters the chest, involving the mediastinal organs, pleura, lungs and heart in the inflammatory process.
- Sepsis. Infection of the whole body due to the spread of bacteria through the bloodstream.
It is important to remember these dangers and treat purulent inflammatory processes in time, wherever they may be.
Prevention
Prevention is better than cure. Common truth is always true. Therefore, physicians advise their patientsmaintain immunity at a high level, harden and seek help in time.
An important role is also played by the elimination of chronic foci of infection, such as inflamed tonsils or adenoids and carious teeth. It is necessary to visit the dentist and therapist regularly to control this process.
