I came down with an unrelenting sore throat about 15-20 years ago. For years I have tried to be discreet in prescribing antibiotics in most of my patients, for fear of causing resistance in bacteria to the antibiotics. I did for me what I did for most of my patients, which was to avoid the antibiotics. However, after a week the sore throat was getting worse, it was starting to keep me from opening my mouth normally and I was running a fever. I called my friend, an ears, nose and throat doctor who practiced at our local clinic with me. 

He squeezed me into his schedule and took a look at my throat. I noted his eyes got a little wide and then he got up and left the room, returning with a large syringe attached to a big bore needle. It was so quick I didn’t have time to resist and he placed that huge needle into my throat, stabbed the left tonsil, and came back with a syringe full of brown liquid. He smiled and said, “You have a peritonsillar abscess.” 

I had pain localized to the left side of my throat which was made worse with swallowing and which was suspicious for peritonsillar abscess. Other symptoms that could indicate such a diagnosis include swollen tonsil or tonsils, uvular deviation away from the abscess, a mouth that doesn’t open fully, purulence of one or both tonsils, drooling, swollen neck-lymph nodes and finally, a muffled voice.       

Usually there are two organisms growing which makes this condition a double threat. If the infection is allowed to spread, the invasion of many layers of neck tissue can occur which leads to a progressive extension of the infection into deep tissue and possibly a dismal death. The infection can also spread to the other tonsil, which, when swollen and pushed up against the opposite swollen tonsil, can block air flow and cause death from suffocation.

My doctor immediately sent me down to an infusion room and started the daily intravenous dose of an antibiotic that would be repeated daily for a week. This was not the first time or the last that antibiotics saved my life. Following this experience, I looked much more carefully at every patient with a sore throat, and, although I was still careful about over-prescribing antibiotics, I prescribed antibiotics more often for swollen and ugly tonsils after that.

Richard P. Holm, MD is founder of The Prairie Doc®. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook.