Purulent inflammation in the oral cavity today is often diagnosed in medicine. One of these pathologies, which is characterized by a severe course, is paratonsillar abscess of the tonsils. This disease is also called phlegmonous tonsillitis, it occurs in people of different sexes, most often between the ages of fifteen and thirty. The risk group includes people who have a compromised immune system, metabolism, as well as those who have a long history of smoking. The appearance of purulent inflammation is caused by infection in the tonsils from festering follicles, damage to the pharynx, inflammation of the gums and other dental diseases.
Problem description
Paratonsillar abscess - inflammation of the tissue of the tonsils of a purulent nature, the last stage of paratonsillitis, which is one of the most severe forms of damage to the pharynx. In 80% of cases, the cause of the development of the disease is chronic tonsillitis. The disease most often develops in autumn or spring. If left untreated, it provokes the development of complications such as neck phlegmon,mediastinitis, sepsis.
The causative agents of the disease are streptococci, pneumococci or Candida fungi. With the defeat of the tonsils, their recesses are filled with pus, usually the focus of inflammation is one-sided. After regular acute inflammation, the tissue of the tonsils is covered with scars, which contribute to the disruption of the outflow of purulent discharge from large depressions, so it is not completely cleared. As a result of this, the infection spreads into the paratonsillar space, and a paratonsillar abscess of the throat develops. When the immune system is impaired, the infection penetrates deep into the tissues.
Abscess looks like a round formation of red color, through the surface of which yellow contents are visible. On palpation, some area of the formation will be soft due to the content of pus in it. The pharynx is displaced in the direction opposite to the abscess.
Disease forms
In medicine, the following forms of pathology are distinguished:
- Anterior (anterosuperior) abscess, in which tissue damage occurs over the tonsils. Usually ulcers open on their own. This form of the disease occurs most often.
- Posterior abscess is characterized by tissue damage between the posterior arch and the edges of the tonsils. Pathology ranks second in prevalence. In this case, there is a risk of inflammation moving to the larynx, which can cause difficulty in breathing.
- Lower abscess is caused by the development of purulent inflammation at the lower pole of the tonsil. Pathology in most casesdevelops due to diseases of the gums and teeth.
- A lateral abscess forms between the pharyngeal wall and the lateral edge of the tonsil. This pathology is considered the most severe and occurs in 5% of patients. In this case, there is a risk of an abscess rupture in the neck tissue.
Causes of disease
Paratonsillar abscess is provoked by the ingress of pathogenic microorganisms into the tissues of the tonsils. Usually, the disease acts as a secondary pathology, forming as a complication of chronic tonsillitis.
Common causes of the disease include:
- infection of the pharynx with pathogenic bacteria as a result of the development of pharyngitis, tonsillitis or tonsillitis;
- dental diseases such as gingivitis, caries, gum disease;
- infection in the throat through the middle ear;
- development of purulent inflammation in the salivary glands;
- damage to the mouth and neck, followed by infection of the wound.
These phenomena are possible only in violation of human immunity.
Risk group
The risk group includes people who have the following pathologies:
- diabetes mellitus;
- anemia;
- cancer disease;
- HIV infection;
- obesity;
- congenital malformations of the tonsils and pharynx;
- nicotine abuse;
- hypothermia.
Symptoms of the disease
Paratonsillar abscess manifests symptoms in the form of a strong unilateral pain syndrome that occurs when swallowing. In someIn some cases, the pain may be bilateral. Over time, pain begins to spread to the ear and lower jaw. Along with this, there is a strong increase in body temperature, weakness develops, headache, and sleep is disturbed. Lymph nodes located on the neck increase, an unpleasant odor appears from the oral cavity. The progression of the disease leads to the development of a spasm of the masticatory muscles, the person's speech changes, the pain intensifies when the head is turned.
Unlike angina, the pain syndrome in this pathology is more acute, present even in a calm state. Tends to aggravate when making any movements, gives to the ear and teeth.
Often on the sixth day, a paratonsillar abscess, a photo of which confirms the severity of the disease, leads to the fact that purulent cavities are opened. This phenomenon is accompanied by a relief in the human condition, a decrease in body temperature, the appearance of an admixture of pus in saliva. In some cases, the breakthrough of the abscess is observed on the eighteenth day. If pus enters the peripharyngeal space, the abscess does not open, so the person's condition only worsens.
Paratonsillar abscess of the throat has the following symptoms:
- severe sore throat;
- spasm of masticatory muscles;
- swallowing disorder;
- enlarged cervical lymph nodes;
- strong increase in body temperature;
- shortness of breath, shortness of breath;
- bad breath;
- developmentemotional stress;
- self-opening of an abscess.
Stages of development of pathology
Paratonsillar abscess of the throat (symptom photo attached) has three stages of development:
- The first is the edematous stage, which is characterized by swelling of the tissues of the tonsils, signs of inflammation and other symptoms of the pathology are absent. At this stage, the disease is rarely diagnosed.
- The second is the infiltration stage, which is caused by the appearance of hyperemia, the development of pain, and an increase in body temperature.
- Third - abscessing stage, which develops on the fifth or sixth day of illness. It is characterized by deformation of the pharynx and protrusion of a large purulent formation.
Complications and consequences
Paratonsillar abscess of the throat, the symptoms and treatment of which will be discussed in detail in the article, usually ends in recovery with timely effective therapy. Otherwise, purulent inflammation spreads into the pharynx, which can cause damage to its walls during surgical intervention to open the abscess. Also, an opening of a paratonsillar abscess is sometimes observed, in which pus enters he althy tissues that are nearby.
These phenomena can provoke a number of complications:
- phlegmon of the neck and throat tissues;
- development of sepsis;
- laryngeal stenosis leading to suffocation;
- purulent lesion of the heart, aorta and veins;
- thrombophlebitis, abscessbrain;
- meningitis, encephalitis;
- Ludwig's angina;
- tissue necrosis;
- jugular vein thrombosis;
- development of toxic shock;
- appearance of bleeding from large vessels of the neck.
Some complications can be fatal and require immediate treatment.
Survey methods
Diagnosing a paratonsillar abscess of the throat is not difficult due to the presence of vivid symptoms of the pathology. The diagnostic examination includes the following points:
- Studying the anamnesis and complaints of the patient. This pathology develops, mainly on the fifth day after acute tonsillitis. The otolaryngologist also pays attention to the presence of foci of infection and possible damage in the oral cavity.
- Examination of a patient showing limited head movement, swollen lymph nodes, fever, and bad breath.
- Pharingoscopy is always used, as it is the most informative diagnostic method in this case. This technique makes it possible to identify the development of a spherical formation, which is covered with an edematous mucous membrane. Inside this formation, purulent contents can be seen. There is also a deformation of the pharynx, pushing back the tonsil.
- Laboratory blood tests.
- Bacteriological culture to identify the causative agent of infection, as well as its sensitivity to antibiotics.
- Instrumental diagnostics: ultrasound and CT of the neck, radiography of the head. These methods are used to determinespread of the abnormal process to he althy tissues and organs.
The doctor differentiates pathology from diseases such as diphtheria, scarlet fever, cancerous tumors, carotid aneurysm, mediastinal abscess.
Therapy of disease
Paratonsillar abscess treatment involves one that is aimed at eliminating the focus and the causative agent of infection, stopping inflammation, reducing the risk of complications. Treatment of the disease is carried out in a hospital. For this, surgical, medical and complex therapy is used.
Drug treatment is carried out at an early stage of the development of the disease. In this case, the following groups of drugs are prescribed:
- Broad-spectrum antibiotics. An effective drug in this case is Amoxicillin. Tetracycline antibiotics do not work.
- Macrolides are used when antibacterial drugs did not give the desired result. In this case, third-generation cephalosporins are prescribed.
The doctor, together with the above remedies, prescribes painkillers, anti-inflammatory and antipyretic drugs, vitamins, immunomodulators. Gargling with antiseptic solutions is also recommended.
Surgery
In the second stage of the pathology, paratonsillar abscess, the symptoms and treatment of which are now being considered, involves the use of surgical intervention. The doctor opens the abscess with an incision. But such a procedure does not always lead to the patient's recovery, since in some cases the hole is glued with fibrin, so it becomes necessary to expand the wound. In this case, drainage is performed for five days under local anesthesia.
In severe cases, an abscessotonsillectomy is performed, in which the abscess is emptied along with the removal of the affected tonsil. This makes it possible to completely eliminate the source of infection. After that, the areas are cleaned with disinfectant solutions for several days. The doctor also prescribes an antibiotic. Physiotherapy may be used to speed up wound healing.
Rehab
During the rehabilitation period, the patient is prescribed drug therapy, which includes the following groups of drugs:
- Antibacterial agents in the form of intramuscular injections, such as Ceftriaxone or Penicillin. The choice of drug will depend on the causative agent of the infection.
- The introduction of "Hemodez" to detoxify the body.
- Gargling with antiseptic solutions.
- Preventing the development of candidiasis when using antibiotics.
- Antihistamines.
- NSAIDs to eliminate pain and inflammation.
Usually, all drugs are given as injections due to the patient's acute sore throat. Recovery occurs in three weeks. With the development of complications, the prognosis worsens,possible fatal outcome.
Forecast
Prognosis of the disease is favorable subject to timely and effective treatment. In severe cases, sepsis can begin, leading to death. Due to the high risk of developing negative consequences, pathology therapy is carried out in a hospital.
Prevention
In order to prevent, first of all, it is necessary to restore the immune system. It is also recommended to timely treat diseases of the nose and throat, monitor oral hygiene, visit the dentist regularly, and get rid of addictions. Physical activity, hardening, proper nutrition and a he althy lifestyle are good for strengthening immunity.
Paratonsillar abscess is a serious disease that can be dangerous to he alth and even human life. Therefore, at the first manifestations of pathology, it is immediately necessary to consult a doctor for diagnosis and treatment. If left untreated, severe complications can develop, which are often fatal.
