What is it about ?
The tonsils are found at the back of the throat. They are made up of glandular tissue capable of capturing incoming microbes and eliminating them. They are therefore part of our defense system against infections from outside. If the tonsils can no longer control the amount of germs, they become inflamed. The microbes involved are most often viruses, sometimes bacteria.
If the inflammation is complicated by the formation of pus, which accumulates, an abscess appears. Treatment includes, among other things, puncturing the abscess with a needle or an incision to remove the pus. This procedure is called drainage.
What is its frequency?
Every year, 5% of the population goes to the doctor for a sore throat1. Most often, the condition is mild and caused by a virus or bacteria. In 0.2% of cases, the sore throat is complicated by an abscess
How to recognize it?
The main symptoms are fever, a sore throat and difficulty swallowing. The neck may be swollen and painful. There are also general symptoms, such as headache and muscle pain. The whole thing is sometimes preceded by a cold.
If the swelling gets worse, it may not be possible to swallow solid food. In this case, food and saliva flow out of the mouth (in the child). The passage to the airways may be blocked, causing difficulty in breathing.
How is the diagnosis made?
The diagnosis is made on the basis of an examination of the throat: the abscess is visible as a large red swelling in the back of the throat, most often on one side, but sometimes on both sides.
How does drainage work?
If the swelling is still limited and the patient is not too sick, one can try to treat with antibiotics first. Their effect should always be checked after a maximum of two days.
Children, seriously ill adults, people with a large abscess or with an abscess on both sides, and people who have difficulty breathing are referred to an ENT specialist. Under local throat anesthesia, it pricks the abscess with a needle to suck out the pus. The next day a check takes place.
If healing is slow or the abscess cannot be emptied with a needle, an incision should be made to aspirate the pus through a catheter. Treatment with antibiotics is also started. After an incision, a check-up is also carried out the next day. If necessary, this intervention will be repeated.
Because the pain often prevents enough drinking, hospitalization is necessary to receive a fluid infusion.
In children and people who have recurrent abscesses, the tonsils may eventually be withdrawn.
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