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What Are the Signs of a Peritonsillar Abscess? An ENT in Gangnam, Seoul Explains

Answered by Dr. Kim Yoo Suk, MD · Board-certified otolaryngologist · Former professor, Yonsei & Ajou University · Consultations in English

When a sore throat becomes an abscess

A peritonsillar abscess, sometimes called quinsy, is a collection of pus that forms between the tonsil and the muscles of the throat wall. It usually develops as a complication of tonsillitis, often in teenagers and young adults. It is the most common deep infection of the head and neck, and it requires prompt treatment.

Warning signs to recognize

• One-sided severe throat pain that keeps getting worse over a few days
• Trismus: difficulty opening the mouth fully because of muscle spasm
• Muffled "hot potato" voice
• Painful or difficult swallowing, sometimes to the point of not swallowing saliva
• Drooling
• Ear pain on the same side
• Fever, chills, and feeling very unwell
• Bad breath and swollen, tender neck glands
• The uvula pushed toward the opposite side

Seek emergency care immediately if

• You have difficulty breathing or noisy breathing
• You cannot swallow liquids or your own saliva
• Neck swelling is spreading or the neck is stiff
• You feel confused or extremely unwell

These may indicate airway compromise or spread of infection into deeper neck spaces.

How it differs from ordinary tonsillitis

Tonsillitis usually affects both sides fairly equally, and you can open your mouth normally. An abscess typically makes one side much worse, causes trismus, and changes the voice. Symptoms that worsen despite antibiotics are another clue.

How it is treated

• Drainage: needle aspiration or a small incision under local anesthesia to release pus, which brings rapid relief for many people
• Antibiotics: to clear the remaining infection
• Pain control and fluids: sometimes intravenous fluids if swallowing is very difficult
• Hospital care: when the airway is at risk, the person cannot drink, or the infection is extensive

Imaging such as CT may be needed when the diagnosis is unclear or deeper spread is suspected.

Will I need my tonsils out?

After one abscess, many people never have another. If abscesses recur, or if you also have frequent tonsillitis, tonsillectomy is commonly recommended. A history of peritonsillar abscess is one of our clinic's listed criteria for considering tonsillectomy.

What we do at Gangnam Yonsei ENT

Dr. Kim Yoo Suk, a board-certified otolaryngologist and former assistant professor at Ajou University School of Medicine, examines the throat and neck to distinguish severe tonsillitis from an abscess, and can use a laryngoscopy to check the airway. When an abscess is suspected and the patient is stable, drainage and treatment are arranged; when there are airway warning signs or the infection needs inpatient care, prompt hospital referral is made.

Because timing matters, message us on WhatsApp at +82-10-5344-4464 if you have these symptoms during our opening hours. Outside of hours, go to an emergency department. See location and hours.

Related questions

Read when adults should have their tonsils removed and when a sore throat needs a doctor.

Related questions

Can a peritonsillar abscess go away with antibiotics alone?

Early peritonsillar cellulitis, before pus collects, may respond to antibiotics. Once an abscess has formed, drainage is usually needed along with antibiotics. A doctor's examination is required to tell the difference and decide on treatment.

Is draining a peritonsillar abscess painful?

The area is numbed with local anesthetic first. Drainage can be uncomfortable, but many people feel significant relief within hours because the pressure from the pus is released. Pain medication helps during recovery.

Can a peritonsillar abscess come back?

Most people have only one episode, but recurrence is possible, especially in those with frequent tonsillitis. If abscesses recur, tonsillectomy is commonly recommended to prevent further episodes, and your doctor will explain the timing and recovery involved.

This answer is general medical information written and reviewed by an ENT specialist. It is not a diagnosis. Please see a doctor for an examination. In an emergency in Korea, call 119.