Paratonsillar abscess (paratonsillitis) - Symptoms

In most cases the process is unilateral; bilateral paratonsillitis, but according to various authors, occurs in 1-10% of cases. Tonsillogenic paratonsillitis usually develops several days after the end of tonsillitis or another exacerbation of chronic tonsillitis.

The disease begins with the appearance of a sharp, often one-sided pain in the throat when swallowing, which later becomes constant and intensifies when trying to swallow saliva. Irradiation of pain to the ear, teeth of the corresponding side is possible.

The patient's condition is usually severe and continuously worsens: headache, fatigue, weakness appear; the temperature rises to febrile numbers. Bad breath is noted. Trismus, a tonic spasm of the masticatory muscles, occurs to varying degrees. The appearance of trismus, according to most authors, indicates the formation of a peritonsillar abscess.

On the affected side, the regional lymph nodes swell significantly and become acutely painful upon palpation. Due to the involvement of the neck muscles and cervical lymph nodes in the inflammatory process, movements of the head and neck become painful; the patient often prefers to keep his head tilted to the affected side. When swallowing, liquid food partially enters the nasopharynx, nose and larynx. Speech becomes slurred and nasal.

The temperature reaction is usually pronounced, especially in the first days and during the abscess formation period. In some cases, especially with recurrent paratonsillitis, the temperature is subfebrile. After the abscess opens, which can occur spontaneously usually on the 3rd-6th day from the onset of the disease, the patient's condition improves sharply, the temperature decreases. With a protracted course, a breakthrough of pus can occur on the 2nd-3rd week. With a deep location of the abscess, its spontaneous opening often does not occur, and suppuration may spread to the peripharyngeal space.

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