peritonsillar abscess
Introduction
Introduction to abscess around the tonsils Abscess around the tonsils is a purulent inflammation in the space around the tonsils. Early stage is cellulitis, called inflammation around the tonsils, followed by the formation of abscesses, called abscess around the tonsils. The disease is often secondary to acute tonsillitis or acute episodes of chronic tonsillitis. After 3 to 4 days of acute inflammation of the tonsils, the fever continues to retreat or worsen, and the body temperature rises above 39 °C. The sore throat is intensified, especially when swallowing. Often limited to the affected side, it can be radiated to the ear and neck. Its main features are swallowing pain, difficulty swallowing, saliva outflow, difficulty in opening the mouth, unclear language, tone change, and physical weakness. When the condition is serious, the patient's head is biased toward the affected side and is not easy to rotate. When the language is like the mouth is not clear, the mouth can not be enlarged, and there is a lot of sticky saliva flowing out of the mouth. basic knowledge The proportion of illness: 0.3% Susceptible people: no special people Mode of infection: non-infectious Complications: pneumonia, parapharyngeal abscess
Cause
Causes of abscess around the tonsils
Most of the tonsils around the tonsils are complications of acute suppurative tonsillitis. Due to poor drainage of the tonsils, especially the upper crypts or deep follicular purulence, the infection develops deeper, penetrates the tonsil capsule into the periton, and inflammation around the molars. It can also develop into the interstitial space of the tonsils, which is the first inflammatory infiltration, that is, the inflammation around the tonsils, and then the abscess is formed. The abscess is mostly located in front of the tonsils, that is, between the tongue and the tongue and between the peaches, which are located above or below the tongue. It is rare and often occurs on one side. Its pathogens are Staphylococcus aureus, beta-hemolytic streptococcus, streptococcus aureus and anaerobic streptococci.
Prevention
Prevention of abscess around the tonsils
1, seafood hair, help fire, moving wind, oysters, irritating diet strict, suitable for liquid or semi-liquid diet.
2, try to ban the sound.
3, take the medicine seriously (spraying).
4, within 24 hours after incision or self-destruction, should rest and rest, if necessary, take the head low and high, in order to facilitate the discharge of pus.
5, inserted in the wound in the wound line, pay attention to not fall off, a new one when it falls off.
6, if the mouth is not clean, you can take borax solution or silver licorice soup as a mouthwash, frequently gargle.
7, after the wound healing, it is best not to eat aquarium fish for two weeks, otherwise the stench is bad.
8, the disease must always pay attention to keep the stool smooth.
Complication
Complications of abscess around the tonsils Complications, pneumonia, parapharyngeal abscess
Inflammation spreads down, can cause acute inflammation of the pharynx and throat, especially the posterior lower abscess, which can cause upper airway obstruction, rapid dyspnea, inflammation spread through the pharyngeal wall to invade the parapharyngeal space, forming parapharyngeal abscess, a few cases Can be complicated by carotid sheath infection, jugular vein thrombosis, sepsis, suppurative neck lymphadenitis, etc., if abscesses in the sleep and pus into the throat and trachea, asphyxia or aspiration pneumonia, but rare.
Symptom
Symptoms of abscess around the tonsils Common symptoms chills lymph nodes swollen tongue thick greasy secretions dysphagia high fever
After 3 to 4 days of acute inflammation of the tonsils, the fever continues to retreat or worsen, and the body temperature rises above 39 °C. The sore throat is intensified, especially when swallowing. Often limited to the affected side, it can be radiated to the ear and neck. Its main features are swallowing pain, difficulty swallowing, saliva outflow, difficulty in opening the mouth, unclear language, tone change, and physical weakness. When the condition is serious, the patient's head is biased toward the affected side and is not easy to rotate. When the language is like the mouth is not clear, the mouth can not be enlarged, and there is a lot of sticky saliva flowing out of the mouth.
Often secondary to acute tonsillitis, especially acute chronic tonsillitis. Foreign bodies and trauma can also cause the disease, but it is rare, mostly occurs on one side, and is common in adults. One side of the sore throat is severe, reflected to the ipsilateral ear, aggravated when swallowing, difficult to open mouth, runny, speech is not clear like mouth food, fever, general malaise, acute illness.
Examine
Examination of abscess around the tonsils
It can be seen that the pharyngeal mucosa is congested, and the affected side is congested with soft palate. The abscess is common between the upper pole of the tonsil and the tongue and arch. The area is obviously raised, and the soft palate and the uvula are pushed to the opposite side. If the abscess is located on the upper part of the tonsil and the tongue Between the bows, the upper edge of the tongue is raised, the tonsils are covered and pushed inward and downward. If it is located between the tonsils and the pharyngeal arch, the pharyngeal arch is raised, the tonsils are pushed forward and downward, and the affected neck and mandibular lymph nodes Swelling, according to the diagnosis of symptoms and signs is not difficult, usually according to the onset of 4-5 days, sore throat and local uplift is obvious, the experimental puncture in the most uplift can be clearly diagnosed.
Diagnosis
Diagnosis and diagnosis of peritons around the tonsils
Differential diagnosis
Parapharyngeal abscess
The pharyngeal side wall of the affected side and the tonsil are pushed inwardly, and the mouth opening is limited, but the inflammation of the pharynx is light, the tonsil itself has no obvious lesions, the radioactive pain on the neck side is severe, and there is often an inflammatory abscess and obvious tenderness.
2. Wisdom tooth pericoronitis
More with the formation of the lower jaw and the formation of periodontal pockets, the sacral flap and surrounding soft tissue swelling, pain, inflammatory swelling can spread to the tongue and arch, but the tonsils and uvula are not affected.
3. tonsil abscess
For the abscess of the tonsil itself, the purulent sputum can be punctured in the tonsils, and the pus outflow can be seen from the crypts on the tonsils. The tonsils on the affected side are swollen, and the inflammation infiltrates into the surroundings, but no mouth is restricted.
4. Purulent mandibular inflammation
It is an acute inflammation at the bottom of the mouth, forming a mesate cellulitis. There is an inflammatory mass at the bottom of the mouth and under the armpits. The tongue is raised, the tongue is painful, the tongue is difficult to stretch, the mouth is restricted but the jaw is closed, and the infection is invaded. To the pharynx, the upper respiratory tract obstruction may occur in the larynx, and the soft palate and the lingual arch may be hyperemia. This disease is caused by odontogenic infection.
