A pharyngeal abscess is an accumulation of pus that lies encapsulated in a newly formed tissue cavity. The pharynx joins the oral and nasal cavity and leads to the larynx. Abscesses in the throat can occur when a purulent tonsillitis or an inflammation of the thyroid gland spreads in the pharynx. A distinction is made between abscesses that lie behind the tonsils (retropharyngeal abscesses), abscesses next to the throat (parapharyngeal abscesses) and almond abscesses (peritonsillar abscesses).
Causes of throat abscess
An abscess in the throat is caused by the spread of a purulent inflammation. The inflammation is caused by bacteria – in most cases streptococci. Inflammation of the thyroid gland (thyroiditis) or the tonsils (tonsillitis) is the most common cause of abscesses in the throat.
An abscess can also be caused by a purulent lymph node inflammation. If the original inflammation is not treated in time or the wrong antibiotics are used, the pathogens spread to the surrounding tissue and an abscess may develop. The body tries to fight the infection and encapsulates the inflammation with a connective tissue envelope from the healthy tissue.
Within this cavity, the lost tissue and bacteria accumulate in the form of pus and an abscess has formed. If the immune system is not able to eliminate the infection and the pus accumulation, there is a risk that the bacteria can penetrate the encapsulation. Then the inflammation spreads to the surrounding tissue and in the worst case can spread to the blood, brain or chest. Serious and life-threatening complications are the result.
Diagnosis of the throat abscess
To diagnose an abscess in the throat, the doctor palpates the neck for swellings and protrusions, whereby abscesses located deep in the throat tissue are very difficult or impossible to palpate. Imaging techniques such as ultrasound or magnetic resonance imaging (MRI) help to visualize and precisely localize the abscess in the throat. In a blood test, the high levels of inflammation in the blood indicate that there is an infection in the body, but not that it is an abscess in the throat.
Associated symptoms of a throat abscess
The symptoms of an abscess in the throat are varied and depend on the location of the inflammation. The general symptoms include severe difficulty swallowing and unilateral sore throat that extends to the ear. Depending on how deep it is, the abscess may be palpable as a distinct, shiftable swelling on the neck or may even be visible as a bulge of the throat wall under the skin.
Due to the swelling, patients have difficulty speaking and the voice sounds different. Classical accompanying symptoms of a throat abscess are fatigue, malaise and a general feeling of illness, as is the case with a cold. As a reaction of the body to the inflammation, fever often occurs.
The accumulation of pus in the abscess contains bacteria that produce putrefactive gases and thus lead to severe bad breath. The abscess causes a feeling of tension in the neck and severe pain, which radiates and can manifest itself as earache, neck pain or headache. The skin above the pus accumulation is usually reddened and warm.
The patient can often only move the neck to a limited extent and thus involuntarily adopts a relieving posture, which leads to muscle tension. A further symptom can be a disorder of the mouth opening, the so-called lockjaw or jaw lock. Here, the jaw muscles are affected by the abscess and the mouth can no longer be opened properly.
If the inflammation spreads from the abscess to the surrounding tissue, nerves or muscles in the throat area can be permanently damaged. In the worst case, the bacteria can enter the bloodstream and cause blood poisoning. The inflammation can also spread to the chest area and the lungs lying there. Patients then suffer from additional symptoms such as shortness of breath and a strong feeling of tightness in the chest.