When we get tonsillitis, but there is always a chance of complications. Even if it is a banal tonsillitis that bothers us after hypothermia or excessive eating of ice cream. One of the most common concomitant pathologies is a paratonsillar abscess. Symptoms of a paratonsillar abscess are neck edema, fever and a foreign body feeling. All of them are found with ordinary angina, so it is difficult to immediately recognize an additional disease. Patients try to be treated at home until the very end, but after raising the temperature to 40 degrees they still seek help from a doctor.
The essence of pathology
An abscess in medicine is called inflammation of the soft tissues, accompanied by the formation of pus. In fact, this is an accumulation of purulent detritus under the skin, mucous membranes or inside the fascial cases. If the process extends to large areas, then it is already classified as a phlegmon. The reproduction of bacteria or fungi provokes the appearance of this pathology.
Despite the fact that the symptoms of paratonsillar abscess are quite easily tolerated by humans, this is a disease that can result in death. The infected fluid melts the tissues it comes into contact with and can enter the brain, leak onto the neck and even into the chest cavity. This will cause the spread of infection throughout the body, shock and quick death.
Historical sketch
To fully understand the seriousness of this pathology, you can use examples from history. Better to start from ancient times. In the twelfth century BC, the Shah of Khorezm, Ala ad-Din Tekesh, perished from this pathology. It is difficult to blame this person for ignorance and neglect of symptoms, since it was during his reign that the state reached its greatest cultural and political heyday.
There is a version that it was from the paratonsillar abscess that the famous leader of the Seminole Indians, Osceola, died. This happened in 1838, when the Spaniards conquered South America. Again, the medicine of these peoples was at a high level; Europeans did not even hear about many medicines. Therefore, talk about negligence is not necessary.
A writer and philosopher from France, Michel Montaigne, Pope Adrian the fourth and Scottish professor of religious studies, Ian Maclaren and some other celebrities, died of a simple, at first glance, illness.
Kinds
Since the symptoms of paratonsillar abscess are always typical, it is classified among otorhinolaryngologists solely by location. There are four forms of the disease.
- Top. It is the most common form of purulent process. This is due to the anatomical features of the tonsils. The upper surface of the organ experiences a strong bacterial load, as the first to take the blow during the contamination of the inflammatory agent. The disease begins with the appearance of a gentle yellowish coating on the palatine arches.
- The posterior form, when the focus is located between the palatine arch and the tonsil. This is the easiest option for diagnosis, since the site of inflammation is clearly visible. The disease causes significant discomfort to the patient, interferes with speaking, swallowing and opening his mouth. In difficult cases, there may be respiratory failure.
- Bottom form. An abscess captures only the lower part of the tonsil. The cause of this complication, as a rule, are diseases of the teeth and gums.
- Outer form. It is an extremely rare occurrence. In some literature, you can find the name of the lateral paratonsillar abscess. It is with this localization that the highest probability of the spread of infection to neighboring areas.
The disease begins acutely, chronic cases are casuistic and occur only in socially disadvantaged citizens who do not seek medical help right away.
Etiology
Symptoms of a paratonsillar abscess appear when purulent inflammation develops on the tonsil in neighboring tissues, caused by the multiplication and vital activity of bacteria. Most often, staphylococci and streptococci act as an infectious agent, but these can be fungi, opportunistic bacteria, and sometimes even viruses.
Paratonsillar abscess is not an independent disease. As a rule, this is the result of improper or artisanal treatment of angina. Patients believe that sore throat is too simple and unpretentious diagnosis to bother the doctor with such trifles. But in fact, do not neglect your own health, and it is better to seek help at the very beginning than to correct the consequences of your inept actions.
The second cause of abscesses of this localization is chronic tonsillitis. A sluggish infectious process is constantly developing in the body, which poisons a person, makes his immunity weak. All this leads to complications of even the most common cold.
Sometimes paratonsillitis appears after removal of lymphoid tissue from the palatine arches. This may be the result of a poor-quality operation, when part of the tonsils still remained and they recovered to their previous size. Or when the doctor damaged the delicate mucous membrane of the larynx with instruments.
In fourth place in the ranking of the causes of abscess, is caries. This is also a constant focus of infection, which must be sanitized so as not to weaken the body's defenses and not to provoke bacteria “on the offensive”.
Symptoms
How does a paratonsillar abscess develop? Symptoms do not appear immediately, but only three to four days after the invasion of the pathogen into the tonsils. The clinic begins to appear most vividly on the fifth day of the disease.
The very first symptom is pain. At first it causes slight discomfort, but in the process of increasing edema and accumulation of pus, it becomes more difficult to endure it. Pain sensations are localized on the same side as the abscess, but can spread to the ear, upper jaw, neck, maxillary sinuses.
A typical symptom of a paratonsillar abscess is laryngeal edema and the presence of mucosal bulging on the affected side. The fabrics in this place are red, very tight, hot. Because of this “lump”, swallowing and breathing are impaired, and over time, damage to the masticatory muscles — trismus — develops. It becomes difficult for the patient to open his mouth.
Due to the circulation of the infection in the human body, the submandibular, occipital and cervical lymph nodes increase. Sometimes it is even noticeable to the naked eye. The patient hardly turns his head, bends his neck, sleeps poorly. Purulent processes generate bad breath, and the spread of inflammation to the fiber of the neck can cause a hoarse voice. Of the common symptoms, a sharp increase in temperature, weakness, and sleep disturbance are especially distinguished.
Paratonsillar abscess in children
Not only in adults, a paratonsillar abscess can be observed as a complication. Symptoms in children often do not correspond to the severity of intoxication, as their immune system is imperfect and does not always adequately respond to infection.
Sore throat can not be removed with any gargles and compresses, the child is not even able to swallow saliva, not like taking medications or eating. In infants, swelling of the throat causes breathing problems until it stops. The second alarming sign for parents should be a change in voice. He becomes hoarse and gurgling, as if their child is holding hot potatoes in his mouth.
Some children have spasms of the muscles of the face and neck, trismus, irradiation of pain in the ear or back of the head. With an objective examination, redness is observed not only on the affected side, but throughout the pharynx.
Diagnostics
How to make a diagnosis of “paratonsillar abscess”? Its symptoms are bright enough so that this can be done on the basis of one clinical picture. The doctor collects an anamnesis, then asks the patient to open his mouth wide and examines the mucous membrane of the oropharynx and larynx. The spatula necessarily touches the site of edema, removes films from the tonsils.
Then directs the patient to laboratory diagnostics:
- clinical blood test;
- clinical analysis of urine;
- bacterial examination of the pharynx;
- sputum culture on diphtheria bacillus.
If necessary, the patient should do a radiography or tomography of the neck to visualize the area of the pathological process.
Treatment
If you have been diagnosed with a “paratonsillar abscess,” treatment at home is strictly contraindicated. If the patient so does not want to go to the hospital, then he is obliged to be in the day hospital under the supervision of staff. Treatment of an abscess can be conservative, surgical, or complex.
Is it possible to get rid of paratonsillar abscess with pills? Antibiotic treatment is effective only at the beginning of the disease, when the bacteria have not yet managed to reach a critical mass and spread throughout the body. But even in advanced cases, doctors must prescribe antibacterial agents to prevent sepsis and reduce the effects of intoxication.
Locally prescribed rinses with antiseptics (Chlorophyllipt, Furacilin, warm hypertonic solutions) and ointments that relieve pain and inflammation.
Folk remedies
Is paratonsillar abscess treatment possible without surgery? Traditional medicine responds with a categorical rejection. Therapy at home, exclusively by artisanal methods, can become dangerous to life and health. But on the other hand, grandmother's recipes will be just in time as an adjuvant against edema and sore throat.
What is required to calm a paratonsillar abscess? Treatment with folk remedies involves the use of honey and bee products. This primarily relates to propolis, which combines the properties of an antiseptic and an immune stimulant. For rinsing, tincture of their fir cones with the addition of coniferous essential oils is well suited.
Dissection of the abscess
It is impossible to diagnose a paratonsillar abscess according to the photo. Symptoms, of course, are very colorful, but doctors like to “look with their hands”, therefore, with signs of this ailment, it is recommended to run for a consultation with a surgeon.
The doctor examines the patient, renders a verdict and sends an abscess to open. The whole process takes place in the clinic and takes 20 minutes on the strength. Having anesthetized the inflamed area, the surgeon makes several incisions and collects the pus that has appeared in the tray. Then inserts a drain (tube or rubber strip) to improve fluid outflow. Sometimes, along with the opening of the abscess, the glands are also removed.
Complications
What can end a paratonsillar abscess? Symptoms and treatment do not cause additional questions among ordinary people, since everything is logical and understandable. But if you evade therapy, then the pathological process can expand and lead to serious consequences:
- Phlegmon neck. Pus melts fatty tissue and flows under the skin of the neck, inflammation builds up, and ulcer and necrosis may even appear.
- Mediastinitis. If with a phlegmon of the neck the patient does not go to the hospital and waits, then the pus moves further and enters the chest, involving the mediastinum, pleura, lungs and heart in the inflammatory process.
- Sepsis. Infection of the whole body due to the spread of bacteria with blood flow.
It is important to remember these dangers and to treat purulent inflammatory processes in time, wherever they are.
Prevention
Better to warn than to heal. Conventional wisdom is always true. Therefore, doctors recommend that their patients maintain immunity at a high level, harden and seek help in time.
The elimination of chronic foci of infection, such as sore tonsils or adenoids and carious teeth, also plays an important role. You must regularly visit the dentist and therapist to monitor this process.