In the neck, numerous fascial planes create a variety of potential spaces where infection can become loculated to form a phlegmon or a full-fledged abscess. Although these processes are now uncommon, prompt recognition is mandatory because antibiotics and surgical drainage are required to control infection and to prevent obstruction of the airway, invasion of vital neurologic and vascular structures, and spread of infection to the mediastinum and bloodstream. Group A streptococci are the primary cause of the condition, though most peritonsillar abscesses also harbor mixed oral bacteria, with a predominance of anaerobes.
Patients have fever and sore throat, often with pain referred to the ear.
Trismus occurs in some patients. CT scans are helpful in diagnosis and management. Treatment consists of parenteral penicillin and surgery. Patients have fever and systemic toxicity as well as neck pain, dysphagia, muffled voice, and respiratory stridor. Physical findings include erythema and bulging of the posterior wall of the pharynx.