Peritonsillar Abscess: Symptoms, Risks, and Treatment Options

Peritonsillar abscess

Hello, may I ask why when I go to the hospital and tell them I can't breathe, I'm wheezing, and my heart hurts, they only give me sedatives or don't give me any medication at all and tell me to go home and manage it myself? I ended up risking my life by taking the sedatives, which made things worse, and I was paralyzed for three years, unable to get out of bed.
My throat hurt so much that I couldn't sleep.
When I went to the emergency room, they just gave me a bunch of sedatives again.
Are doctors nowadays just looking at medical history and prescribing medication without actually examining patients? I clearly have symptoms of a peritonsillar abscess: 1.
Infection of one or both tonsils (sometimes one side, sometimes both); 2.
Fever or chills (sometimes a slight fever, sometimes so high I can't sleep); 3.
Inability to fully open my mouth (I can't eat, talk, or see a dentist; my mouth won't open, and I have phlegm); 4.
Difficulty swallowing (it feels like I'm choking when I eat, and I can't breathe while eating); 5.
Occasional headaches; 6.
Mumbled speech (sometimes I can't speak...
I can't breathe, I'm wheezing, and my heart hurts with persistent arrhythmia); 7.
Bad breath (occasionally); 8.
Redness and swelling of the face, mouth, or neck (swollen like a pig's jowl); 9.
Sore throat, usually on one side.
The side that hurts also causes ear pain (sometimes my whole cheek hurts unbearably); 10.
Difficulty swallowing saliva, leading to drooling (occasionally); 11.
Swelling of the glands and lymph nodes in the throat and jaw, which feel soft and may only be on one side (that's exactly it).
Previously, I had a toothache that might have caused streptococcal pharyngitis, and after getting a fishbone stuck and experiencing gastroesophageal reflux, it has now developed into a peritonsillar abscess over three years.
I've seen both large hospitals and small clinics, but they only prescribe sedatives.
Are they sick or deliberately trying to suffocate me? There have been several times when I couldn't breathe and almost died, but thankfully, after taking antibiotics, I felt a bit better and could breathe again.
I've been unable to breathe and eat for three years.
My jaw has been swollen to the point where my friends think I've gained weight...
I don't know when I will get better and stop relapsing.
Last month, I took an antibiotic and felt a bit better (I accidentally ate fried fish and almost suffocated).
Recently, after eating fried food again, the pain and difficulty breathing have returned (the side of my tongue also hurts).
I'm hesitant to take too many antibiotics, so I experience occasional relapses (my stomach hurts terribly).
I ran out of the dentist's office halfway through because I couldn't breathe at all...
Is it because I'm afraid to have an endoscopy that they will never prescribe antibiotics for me? I have to buy antibiotics myself from the pharmacy or take dental antibiotics.
If you ask me why I don't have an endoscopy, it's because I can't breathe at all, and I'm afraid it will block my airway, leading to an emergency tracheostomy, which would be extremely painful.
May I ask if taking dental antibiotics for ten days will make me better...
and prevent relapses? I've been living on luck for the past year or two...
because there have been several times when I couldn't breathe, and my blood oxygen level dropped to 40, almost leading to death...

Pei Pei, 40~49 year old female. Ask Date: 2023/11/14

Dr. Zheng Jueyi reply Otolaryngology

It is recommended to seek medical evaluation for confirmation.
If it is a bacterial infection such as a peritonsillar abscess or tonsillitis, antibiotics may be used for a week.
However, if it is not a bacterial infection, antibiotics will not have a significant effect.
Bacterial infections will improve with antibiotics, but since the environment is naturally filled with bacteria and viruses, it is impossible to avoid reinfection.
The focus should be on improving one's immune system to reduce the chances of infection.

Reply Date: 2023/11/14

More Info

Peritonsillar abscess is a serious condition that can arise from a complication of tonsillitis, characterized by the accumulation of pus near the tonsils. It can lead to severe symptoms, including difficulty breathing, swallowing, and intense throat pain. Your description of symptoms, such as unilateral or bilateral tonsil infection, fever, chills, trismus (difficulty opening the mouth), and significant throat pain, aligns with the clinical presentation of a peritonsillar abscess.

Symptoms and Risks
The symptoms you are experiencing are concerning and suggest that you may indeed have a peritonsillar abscess. The key symptoms include:
1. Severe throat pain: Often unilateral, but can be bilateral.

2. Difficulty swallowing: This can lead to choking sensations and may cause you to feel like you are unable to breathe.

3. Fever and chills: Indicating an infection.

4. Trismus: Inability to open the mouth fully, which can complicate eating and speaking.

5. Swelling: This can lead to visible swelling in the throat and neck area.

6. Halitosis: Bad breath due to the infection.

7. Radiating pain: Pain that may extend to the ears or jaw.

Treatment Options
Treatment for a peritonsillar abscess typically involves drainage of the abscess and antibiotic therapy. Here are the common steps taken:
1. Drainage: This is usually performed by an ENT specialist. They may use a needle or incision to drain the pus, which can provide immediate relief from symptoms.

2. Antibiotics: After drainage, a course of antibiotics is essential to treat the underlying infection. It's crucial to follow the prescribed regimen to prevent recurrence.

3. Pain Management: Analgesics may be prescribed to help manage pain during recovery.

4. Hydration and Nutrition: Maintaining hydration is vital, especially if swallowing is painful. In severe cases, intravenous fluids may be necessary.

Why You May Not Be Receiving Adequate Treatment
It is concerning that you have not received appropriate treatment despite your severe symptoms. Here are a few reasons why this might be happening:
- Misdiagnosis: Healthcare providers may misinterpret your symptoms as anxiety or other non-urgent conditions, leading to inadequate treatment.

- Lack of Urgency: Some medical professionals may not recognize the severity of your symptoms, especially if they are not familiar with peritonsillar abscesses.

- Over-reliance on Medication: There may be a tendency to prescribe sedatives or pain medications without addressing the underlying issue.

Recommendations
Given your history and the severity of your symptoms, I strongly recommend the following:
1. Seek Immediate Care: If you experience difficulty breathing, go to the emergency room. This is a medical emergency.

2. Consult an ENT Specialist: They can perform a thorough examination, possibly including imaging studies, to assess for an abscess.

3. Consider a Second Opinion: If you feel your concerns are not being taken seriously, seek care from another healthcare provider who specializes in throat conditions.

4. Avoid Self-Medication: While antibiotics can be helpful, they should be prescribed by a healthcare professional to ensure the right type and dosage.

Conclusion
Peritonsillar abscess is a serious condition that requires prompt medical attention. Your symptoms suggest that you may be experiencing this condition, and it is crucial to receive appropriate treatment to prevent complications. Do not hesitate to seek emergency care if your breathing difficulties worsen. Your health and safety are paramount, and timely intervention can lead to a full recovery.

Similar Q&A

Understanding Perticnel Abscess: A Rare Medical Condition Explained

Hello! It seems there might be a slight misspelling in the term you provided. The correct term is likely "peritonsillar abscess," which refers to a collection of pus that forms near the tonsils, typically as a complication of tonsillitis. It can cause severe throat pain...

Dr. Lin Qingyuan reply Rare Disease
Xiao Ting: I believe it's a typo! Could you please tell me the patient's symptoms? For example, where is the abscess located? Then I can respond! Professor Lin Qingyuan replied.

Understanding Complications of Peritonsillar Abscess Drainage

Hello Doctor, I have unilateral tonsillitis with significant swelling and pus. After visiting the clinic, I started taking Curam 1000 antibiotics, and today is the second day of treatment. Suddenly, I noticed a lot of pus coming from my mouth, but I am not coughing; it just happe...

Dr. Zheng Jueyi reply Otolaryngology
It is recommended to drink plenty of water and rinse your mouth with clean water frequently. Additionally, take your antibiotics as prescribed, as the typical treatment duration is about one week. It is advised to return for a follow-up appointment after finishing the medication ...

Understanding Perticnel Abscess: Causes, Symptoms, and Treatment Options

Hello, doctor! Could you please help me clarify this term: Peritoneal abscess? Thank you!

Dr. Zhou Ziguang reply Pulmonology
Hello, Xiao Ting: Regarding your question, here are the responses: 1. Perticnel: No such word found; similar term: peritoneal, pertaining to the peritoneal cavity. 2. Abscess: A localized collection of pus caused by bacteria. Dr. Zhou Ziguan.

Understanding Peritonitis: Causes, Complications, and Treatment Options

Doctor: Hello, my wife developed peritonitis 33 years ago due to surgery. She did not undergo surgery for retroperitoneal inflammation due to the severity of her condition; instead, a funnel was placed in her lower abdomen to allow pus from the peritoneal cavity to drain through ...

Dr. Xu Kaixi reply Surgery
Based on your description, the systemic inflammatory response (including the splenic inflammation you mentioned) is caused by peritonitis. The primary treatment typically involves antibiotics, and if there is an intra-abdominal abscess, percutaneous drainage or surgical drainage ...