Almond abscess

definition

Almond abscesses are relatively rare compared to tonsillitis.
A tonsil abscess is a cavity that has formed on or next to the tonsil and is filled with pus. Almond abscesses occur in the vast majority of cases alongside a purulent tonsillitis.

Learn more about the Palatine tonsils

causes

Almond abscesses often occur alongside tonsillitis.

Bacteria are first inhaled and infect one or both tonsils, whereupon tonsillitis develops. Everyone is familiar with the painful inflammation of the tonsils, which in this case is swelling and sometimes covered with pus.
Untreated tonsillitis can spread and trigger a complicated abscess of the tonsils. Urgent treatment is then necessary. In the case of an almond abscess, the pathogens that have penetrated the body migrate next to and around the infected almond.
The immune system recognizes the pathogen and starts sending defense cells into this area of ​​the body. To prevent the bacteria from spreading around the body, the body creates a cavity to trap the bacteria. Scavenger cells and other cells of the immune system begin to destroy the bacteria. Pus forms. If the abscess swells more and more, it can also burst.

General information can be found here: Almonds, abscess

Symptoms

The first symptoms of an almond abscess are mainly difficulty swallowing and pain when swallowing. One or both tonsils are swollen, red and possibly covered with pus.
In the case of an almond abscess, the pharyngeal ring around the uvula does not appear in the usual, curved shape, but is characterized by a flattening on the side where the abscess is located. The uvula called the uvula is often pushed aside. The known arch-shaped structure is canceled because the abscess behind the arch takes up a lot of space and thus shifts the structure.
Often the neck is clearly tender on the outside on the side on which the abscess is located, numerous lymph nodes can be palpable enlarged (see also: Lymph nodes swollen) and are also tender. Also, due to the spatial displacement of the abscess in the neck area, opening the mouth can be painful or not completely possible. In this case, it is necessary to think about an almond abscess quickly and take appropriate measures, such as seeing a doctor.

Read more on the topic: Swelling on the side of the neck

Furthermore, patients may have general symptoms. High fever, tiredness and exhaustion and a deterioration in the general condition can tie the patient to bed. In addition to the pain when swallowing and the difficulty swallowing, most patients have a lumpy and embarrassed language.
If an almond abscess takes up a large part of the throat, it can also happen that this area becomes increasingly narrowed and obstructed. In this case, the patients would report breathing difficulties.Immediate action is necessary here.

You might also be interested in: Pain in the throat

Are Almond Abscesses Dangerous?

Almond abscesses are one of the most dangerous courses that can be avoided. Depending on when you recognize and treat an abscess in this area, it can lead to a mild and healing process. If you wait a long time and general symptoms appear, an almond abscess can also be dangerous.
This mainly happens when the abscess bursts uncontrollably and pus pours into the space behind the tonsils. In this situation, the germs can spread and multiply throughout the body. If they get into the bloodstream, it can be dangerous sepsis (Blood poisoning) that make intensive medical treatment urgently necessary.
In most cases, however, an abscess is treated early because severe pain leads the patient to the doctor. If large-scale operations have to be performed because of a very large abscess, the risk that structures will be injured in such an operation always increases. Important nerve damage or vascular injuries should be mentioned. For example, after major neck operations that become necessary after abscess treatment, neurological restrictions in swallowing or speaking can occur.

Are Almond Abscesses Stretching?

Almond abscesses are not contagious per se. The pathogens that triggered such an abscess on the tonsil, however, can very well be transmitted.
They correspond to the bacteria that also cause normal tonsillitis. Mostly are Staphylococci or Streptococci Guilty of tonsillitis.
The abscess is an enclosed space. Pathogens can therefore not emerge and infect others. But one has to assume that the corresponding germs are also deposited around the abscess and that they can possibly also be transmitted.
Appropriate preventive measures must be taken. In the time of a sore throat, hygienic measures should be observed in a very special way. The important thing is regular Wash your hands and the disinfection. The person affected can also use disinfecting mouthwashes to clean the mouth.
Furthermore, closeness and kissing and hugging should be avoided, as this is a fast transmission path.

therapy

While you can possibly wait a few days with tonsillitis or take alternative medical measures (gargling, compresses, etc.), an effective treatment of an almond abscess should be started immediately.
This clinical picture involves the so-called preventable, dangerous processes, i.e. conditions that can in part also become life-threatening if no appropriate treatment is started and carried out consistently.
In the case of smaller abscesses that are located locally on an almond and that do not cause any general symptoms other than a sore throat, an attempt can be made to treat exclusively with medication. Come here Antibiotics to use how Cefuroxime 500 mg twice a day for 7-10 days or Amoxicillin 1000 mg 3 times a day for 7-10 days. With every abscess treatment, even if it has to be treated surgically, antibiotics are also given in parallel in order to enable faster healing.
Very advanced abscesses, which cause accompanying deterioration in the general condition, are treated surgically. Diagnosing an abscess is not always easy, as it can sometimes be very deep and can be confused with a simple tonsillitis. If the uvula and / or the pharynx are abnormal, an abscess should be considered. With the help of a cotton swab, this can then be felt by the ENT doctor. There is a wave movement typical of an abscess in this area.
Furthermore, the Ultrasound examination a common way to diagnose an abscess. Here the ultrasound head is placed on the neck from the outside and it is seen whether there is a mass that is typical of an abscess. Such an ultrasound examination or, if the visibility does not bring good results, an ultrasound examination as well, is carried out before every surgical procedure MRI (Magnetic resonance tomography) Examination carried out to plan the operation.
If you have opted for exclusively drug treatment, you can also take additional general measures that are similar to treating a simple tonsillitis and that are intended to help alleviate the symptoms. That would be mentioned cooling inside and outside through ice as well as one Anti-inflammatory through medication - e.g. With Ibuprofen or Diclofenac.

Surgery for a tonsil abscess

Surgical measures to treat a tonsil abscess are always carried out if the size of the abscess cannot be treated exclusively with medication, if the abscess has become deeply detached or if severe general symptoms are caused.
A distinction is made between the superficial simple one in the operative approach Abscess splitting from the profound Abscess clearance.
In the case of abscess splitting, which occurs in the case of a strongly bulging abscess into the throat, the surface of the abscess is pierced by an ENT doctor and the pus that then emerges is suctioned off. You can also try to express the abscess from the outside with a cotton swab. If abscesses go deeper, the abscess needs to be cleaned out. The abscess is cut open and then cleared out. Finally, the skin and the mucous membrane in the throat area are sutured again at this point. In the case of very pronounced, deep abscesses, it may also be necessary to perform an external operation.
These ENT operations are very time-consuming. Parts of the neck must be exposed and the abscess must be completely exposed. Such an operation becomes even more complex if one is already involved Fistulous duct (connects two cavities, see also: Fistula in the mouth) has formed. In most operations, the palatine tonsil is also removed at the same time (see: Remove the almonds). There are two reasons for this. On the one hand, one wants to completely remediate the inflammatory focus and prevent pathogens from migrating from the palatine tonsil after the abscess has been split; on the other hand, an almond abscess represents a complicated course of tonsillitis decided to take this measure.
In all operations, high-dose antibiotics are given in parallel. In operations on abscessed tonsils is a multi-day inpatient stay necessary in the hospital, during which there are also some follow-ups and examinations After the procedure, the inside and outside should be cooled consistently to prevent excessive swelling.

Almond abscesses in children

Abscesses in the area of ​​the tonsils are almost always associated with a previous or accompanying tonsillitis. Because children about 13 times more likely to develop tonsillitis as adults, children are statistically at greater risk of developing tonsil abscess. Treatment is the same as treatment for adults. In order to avoid complications, a quick, surgical measure should be considered in addition to antibiotic treatment.