In some patients who develop tonsillitis, the infection can spread beyond the tonsil itself into the space between the tonsil and the pharyngeal muscles. This in turn produces an abscess in what is known as a peritonsillar abscess. This can be a dangerous condition as the infection can spread to deeper structures or the abscess can spontaneously rupture into the throat. In addition to a severe sore throat, the patient usually has a great deal of difficulty swallowing and opening his or her mouth.
Diagnosis is made on examination and in some cases by needle aspiration of the peritonsillar space through the mouth. Once diagnosed, the abscess will need to be drained to prevent complications. Incision and drainage of the abscess, in most cases can be done in the office using local anesthesia. Young children require general anesthesia for drainage. In patients who have had recurrent peritonsillar abscesses, a tonsillectomy is usually recommended.