Almond abscesses are relatively rare compared to tonsillitis. An almond abscess is a cavity that has formed on or next to the almond and is filled with pus. In most cases, tonsil abscesses occur next to a purulent tonsillitis.
Causes
Almond abscesses often occur alongside tonsillitis. Bacteria are first inhaled and infect one or both tonsils, after which tonsillitis develops. Everyone knows about the painful inflammation of the tonsils of the palate, which in this case swells and is sometimes covered with pus.
Untreated tonsillitis can spread and cause a complicated abscess of the tonsils. Urgent treatment is then necessary. In a tonsil abscess, the pathogens that have entered the body migrate next to and around the infected tonsil.
The immune system recognizes the pathogens and begins to send defense cells to this area of the body. To prevent the bacteria from spreading in the body, the body forms a cave to trap the bacteria. Scavenger cells and other cells of the immune system begin to destroy the bacteria.
Pus is formed. If the abscess swells more and more, it can also burst. You can find general information here: Almonds, Abscess
Symptoms
The first symptoms of a tonsil abscess are mainly difficulty swallowing and pain when swallowing. One or both palatine tonsils become swollen, reddened and possibly also purulent. In a tonsil abscess, the pharyngeal ring around the uvula does not appear as in the usual curved form, but is characterized by a flattening on the side where the abscess is located.
Often the uvula is also pushed to the side. The familiar arched structure is cancelled out because the abscess behind the arch takes up a lot of space, thus shifting the structure. Often the neck is clearly painful from the outside on the side where the abscess is located, numerous lymph nodes can be palpated enlarged and are also painful from pressure.
Also, due to the spatial displacement of the abscess in the neck area, opening the mouth can be painful or even not completely feasible. In this case, a tonsil abscess must be considered quickly and appropriate measures taken, such as consulting a physician. Furthermore, patients may have general symptoms.
For example, high fever, fatigue and exhaustion and a deterioration in general condition can tie the patient to the bed. In addition to the pain when swallowing and in addition to the difficulty in swallowing, most of the patients show a clumsy and embarrassed speech. If an almond abscess occupies a large part of the throat, this area may also become increasingly constricted and misaligned.
In this case, patients would report breathing difficulties. Immediate action is necessary here. Tonsillectomy abscesses belong to the avoidably dangerous courses.
Depending on when an abscess in this area is recognized and treated, it can lead to a mild and healing process. If one waits very long and general symptoms already appear, an almond abscess can also become dangerous. This happens especially when the abscess bursts uncontrolled and pus pours into the space behind the tonsils.
In this situation the germs can spread and multiply throughout the body. If they also enter the bloodstream, a dangerous sepsis (blood poisoning) can be triggered, which makes intensive medical treatment urgently necessary. In most cases, however, an abscess is treated early on 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 of damaging structures in such an operation always increases. Important nerve damage or vascular injuries are worth mentioning. For example, after major neck operations made necessary by abscess treatment, there may be neurological limitations in swallowing or speaking.
Almond abscesses per se are not contagious. However, the pathogens that have caused such an abscess on the tonsils can be transmitted. They correspond to the bacteria that also cause a normal tonsillitis.
In most cases, staphylococci or streptococci are responsible for tonsillitis. The abscess is a closed room. Therefore, pathogens cannot come out and infect others.But one has to assume that there are also germs around the abscess and that they can 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. Regular hand washing and disinfection is important.
The affected person can also clean the mouth area with disinfectant mouthwashes. In addition, proximity and kissing and hugging should be avoided, as this is a fast transmission route. While in the case of tonsillitis it is possible to wait a few days or take alternative medical measures (gargling, compresses etc), an effective treatment of a tonsillitis abscess should be started immediately.
This clinical picture is the so-called avoidable dangerous progressions, i.e. conditions that can sometimes become life-threatening if no appropriate treatment is started and consistently carried out. In the case of smaller abscesses, which are located locally on a tonsil and which do not cause any general symptoms other than sore throat, an attempt can be made to treat them exclusively with medication. In this case antibiotics are used, such as Cefuroxim 500 mg twice a day for 7-10 days or Amoxicillin 1000 mg 3 times a day for 7- 10 days.
In every abscess treatment, even if it has to be treated surgically, antibiotics are also given in parallel to allow faster healing. Very advanced abscesses, which cause accompanying deterioration of the general condition, are treated surgically. It is not always easy to diagnose an abscess, as some of them are deep-seated and can be confused with simple tonsillitis.
If there are abnormalities of the uvula and/or the pharyngeal ring, an abscess should be considered. This can be palpated by an ENT specialist with the help of a cotton swab. A wave movement in this area is typical for an abscess.
Furthermore, ultrasound examination is a common measure to diagnose an abscess. Here, the ultrasound probe is placed on the outside of the neck and it is seen whether there is a mass in the depth that is typical for an abscess. Before every surgical procedure, such an ultrasound examination or, if the visibility conditions do not provide a good result, an MRI (magnetic resonance imaging) examination is performed to plan the operation.
If you have decided on exclusively drug treatment, general measures can be taken in addition, which are similar to the treatment of a simple tonsillitis and which should help to alleviate the symptoms. These measures include cooling of the inside and outside of the tonsils with ice and anti-inflammatory medication such as ibuprofen or diclofenac. Abscesses in the area of the tonsils are almost always associated with a preceding or accompanying tonsillitis.
Since children are about 13 times more likely to develop tonsillitis than adults, children have a statistically higher risk of developing a tonsillar abscess. The treatment corresponds to the treatment of adults. In order to avoid complications, one should consider not only antibiotic treatment but also a speedy surgical procedure.
