Peritonsillar Abscess 

These instructions are for Children’s Hospital of Philadelphia (CHOP) patients who have been diagnosed with a peritonsillar abscess.

Important information about peritonsillar abscess:

Peritonsillar abscess is a collection of pus around the tonsils. One or both tonsils can become infected. The infection may spread to the area around the tonsil. It can then spread down into the neck and chest. Swollen tissues can block the airway. This is a life-threatening medical emergency.

The abscess can break open into the throat. The contents of the abscess can travel into the lungs and cause pneumonia.

Causes of peritonsillar abscess:

• Peritonsillar abscess is a complication of tonsillitis. It is most often caused by a type of bacteria called group A beta-hemolytic streptococcus.

• Peritonsillar abscess most often occurs in older children, adolescents, and young adults. The condition is rare now that antibiotics are used to treat tonsillitis.

• It can be caused by mononucleosis (also called mono), tooth and gum infections.

• People who smoke are more likely to get a peritonsillar abscess. 

Symptoms of peritonsillar abscess include:

• Fever and chills

• Severe throat pain that is usually on one side

• Spasms in jaw, or unable to open mouth (trismus) 

• Ear pain on the side of the abscess

• Difficulty opening the mouth, and pain with opening the mouth

• Swallowing problems - can have increased drooling or unable to swallow saliva

• Facial or neck swelling

• Increased headache/fatigue 

• Muffled voice (Hot Potato) 

• Tender glands of the jaw and throat

• Neck stiffness (torticollis) 

Instructions for treatment of peritonsillar abscess:

• In some cases, peritonsillar abscesses require drainage. This can be done in the emergency department (if tolerated) or the operating room. 

• Give your child the antibiotics as prescribed. It is important to take all the doses to prevent complications.

• Treat your child’s pain and fever with acetaminophen (Tylenol®) or ibuprofen (Motrin®). Following the dosing instructions on the label. Encourage your child to drink fluids to prevent dehydration. 

• Practice good oral hygiene. Brush teeth twice each day and floss daily.

• Do not smoke.

• If your child has repeated peritonsillar abscesses, you should follow up with an ENT specialist 4 to 6 weeks after the infection to discuss surgical options such as tonsillectomy. 

Call your healthcare provider or go to the emergency department if your child: 

• Is drooling or unable to swallow

• Has trouble speaking or breathing

• Is not drinking and looks dehydrated. Signs of dehydration include:

  • Dry mouth, lips and tongue 

  • Not urinating at least 2 times per day 

  • Urine is dark color and smells strong

• Has worsening symptoms while taking antibiotics

Division of Otolaryngology (Ear, Nose and Throat)

215-590-3440

7 days per week/24 hours

Reviewed February 2024 by Tyree D. Smith, MSN, CRNP, CPNP-AC, CORLN, CPEN