Abscess in the throat

definition

An abscess in the throat is a collection of pus that is encapsulated in a newly formed tissue cavity. The pharynx joins the oral and nasal cavities and leads to the larynx. Abscesses in the throat can develop when a purulent tonsillitis or inflammation of the thyroid gland spreads to the throat.

A distinction is made between abscesses that lie behind the tonsils (Retropharyngeal abscesses), Abscesses next to the pharynx (Parapharyngeal abscesses) and almond abscesses (Peritonsillar abscesses).

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Causes of the throat abscess

An abscess in the throat is caused by the spread of a purulent inflammation. The inflammation is caused by bacteria - in most cases these are streptococci.

Inflammation of the thyroid gland (Thyroiditis) or almonds (Tonsillitis) are the most common cause of abscesses in the throat. An abscess can also result from a purulent inflammation of the lymph nodes. If the original inflammation is not treated in time or the wrong antibiotics are used, the pathogens spread to the surrounding tissue and an abscess can develop.

The body tries to fight the infection and encapsulates the inflammation from the healthy tissue with a connective tissue covering. Within this cavity, the submerged tissue and bacteria collect in the form of pus and an abscess has formed. If the immune system cannot clear the infection and the accumulation of pus, there is a risk that the bacteria can penetrate the encapsulation. Then the inflammation spreads to the surrounding tissue and in the worst case can spread to the blood, the brain or the chest cavity. Serious and life-threatening complications are the result.

Diagnosis of the throat abscess

To diagnose an abscess in the throat, the doctor feels the throat for swellings and bulges, whereby abscesses deep in the throat tissue are very difficult or impossible to feel.

Imaging procedures, such as an ultrasound examination or magnetic resonance imaging (MRI), help to visualize the abscess in the throat and to localize it precisely.

When doing a blood test, the high levels of inflammation in the blood indicate that there is an infection in the body, but not that it is an abscess in the throat.

Accompanying symptoms of a throat abscess

The symptoms of an abscess in the throat are diverse and depend on the localization of the inflammation. General symptoms include severe difficulty swallowing and a unilateral sore throat that pulls towards the ear. The boil can - depending on how deep it is - be palpable as a clear, movable swelling on the neck or it may even be visible as a protrusion of the pharynx wall under the skin. Due to the swelling, patients have difficulty speaking and the voice sounds changed.

Classic accompanying symptoms of a throat abscess are fatigue, malaise and a general feeling of illness, as can also be found with a cold. A fever is common in the body's response to the inflammation. The accumulation of pus in the abscess contains bacteria that produce putrefactive gases and thereby lead to bad breath.

The abscess causes a feeling of tightness in the neck and severe pain that radiate and can manifest as an earache, neck pain or headache. The skin over the collection of pus is usually red and warm. The patient can often only move his neck to a limited extent and thus involuntarily adopt a relieving posture, which subsequently leads to muscle tension.

Another symptom can be a disorder of the mouth opening, the so-called Jaw clamp or Lock jaw be. The jaw muscles are affected by the abscess and the mouth can no longer be opened properly.

If the inflammation spreads from the abscess to surrounding tissue, permanent damage to nerves or muscles in the throat area can occur. In the worst case, the bacteria get into the blood and cause blood poisoning there. The inflammation can also spread to the chest and the lungs there. The patients then suffer from additional symptoms such as shortness of breath and a strong feeling of tightness in the chest.

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The emergence of pus in the context of the pharynx abscess

The strong inflammation caused by an abscess in the throat creates pus, which is composed of dead inflammatory cells, bacteria and submerged cell components of the infected tissue.

The formation of pus is part of the body's natural defense reaction against the infection. The body forms a capsule of connective tissue around the pus focus, trying to contain the infection. The bacteria in the collections of pus can cause bad breath.

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Therapy of a throat abscess

In the case of a severe unilateral sore throat and long-lasting swelling of the neck, the suspicion of an abscess in the throat area is likely. In such a case, a doctor must be consulted so that the abscess can be treated as quickly as possible and thus prevent the infection from spreading to healthy tissue.

An abscess in the pharynx must be surgically removed. During the operation, the abscess is cut open and the accumulated pus is sucked out. This will prevent the inflammation from spreading further.

The surgeon removes all of the dead tissue and disinfects the wound with an antiseptic solution. The wound is not sewn, but remains open. The aim of the open wound is to prevent a new abscess cavity from forming. The procedure usually takes less than an hour and is performed under general anesthesia.

If the operation proceeds without complications (e.g. secondary bleeding, wound healing disorders or injuries to nerves in the throat area), the patient can leave the hospital after three to four days of inpatient stay. Following the surgical cleavage of the abscess, the patient is given antibiotic therapy, which combats the pathogen causing the infection and prevents the pus from forming again.

When is an operation necessary?

An abscess in the throat can be life threatening. It is problematic if the abscess is located near blood vessels in the throat, as the infection can then break through into the vessel. This can lead to life-threatening blood poisoning (sepsis) or a brain abscess with loss of brain tissue. The inflammation can also spread to the chest through the throat and affect the lungs or heart. Accordingly, abscesses in the throat are treated as emergencies and must be treated surgically immediately.

During an operation, the abscess is opened and the pus is sucked out. In cases in which the tonsils are also affected by the inflammation, these must also be removed.

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Duration of illness with a throat abscess

If the abscess in the throat is treated properly, the prognosis is good and the inflammation heals completely.Nevertheless, an abscess in the throat is a relatively protracted disease and it can take several weeks for the abscess to heal completely and for the symptoms to completely disappear. In rare cases, the abscess may reappear in the same location and require a second operation.

Almond abscess

As a tonsil abscess or Peritonsillar abscess This is a severe inflammation of the tonsils in the throat. Various viruses and bacteria can cause acute tonsillitis (Peritonsillar inflammation) causing the tonsils to swell and fester. A sequela of peritonsillar inflammation can lead to an almond abscess, but this is only very rarely the case. Almond abscesses occur when tonsillitis is left untreated or the wrong antibiotics have been used to treat it. This allows the inflammation to spread and an encapsulated collection of pus to form on one or both tonsils.

The symptoms of an almond abscess are similar to those of acute peritonsillar inflammation. Those affected suffer from severe difficulty swallowing, a sore throat and a fever. In some cases, the inflammation can also attack the nerves in the muscles of the jaw, making patients unable to open their mouths properly. This symptom is known as a locked jaw.

An almond abscess is an absolute emergency that needs immediate medical attention. To combat the infection, antibiotics are used, which have to be in high doses and are therefore often administered as an infusion. Very large abscesses must be surgically removed and the accumulated pus aspirated.

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Development of abscesses in the pharynx after surgery

In some cases, abscesses can also occur after major operations (e.g. after removal of the tonsils, the so-called Tonsillectomy) arise in the pharynx. Germs penetrate the wound caused by the operation and lead to an infection. The pus that is formed in the process cannot drain, it collects in an encapsulated tissue cavity and an abscess develops.

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Abscess on the roof of the mouth

An abscess can also appear on the roof of the mouth and is caused by various diseases of the oral cavity. Often, erupting wisdom teeth or inflammation in the gums lead to bacterial colonization of the tissue and the formation of encapsulated pus accumulations in the palate area.

A palate abscess is very dangerous because the inflammation can break through into vessels that supply blood to the brain. An abscess in the oral cavity can therefore be life-threatening and must be treated immediately.