The tonsillar phlegmon corresponds to an accumulation of pus at the level of the throat, and more exactly at the level of the tonsils. Amygdala phlegmon is often a complication of angina and requires urgent medical attention.

Definition of tonsillar phlegmon

Tonsil phlegmon is often presented as an abscess in the throat, and more specifically as an abscess in the tonsils. As a reminder, the tonsils are organs of the immune system located in the pharynx at the back of the throat.

An abscess is a local buildup of pus. In this case, accumulation is observed around the amygdala between the pharyngeal wall and the amygdala capsule (membrane surrounding the amygdala). As such, specialists speak of per-tonsillar phlegmon or per-tonsillar abscess.

Causes du phlegmon amygdalien

Tonsil phlegmon is a complication of a disease affecting the tonsils. It often follows sore throat, an inflammatory throat disease affecting the tonsils in particular. Angina is usually viral but can also be caused by infection with bacteria.

Risk factors for tonsillar phlegmon

Poor dental hygiene has been shown to promote the development of tonsillar phlegmon. Having already developed a peritoneal abscess is also considered a risk factor.

It is also suggested that smoking may promote the development of tonsillar phlegmon.

People affected by tonsillar phlegmon

Tonsil phlegmon is presented as the most common abscess of the head and neck regions. The number of new cases per year is estimated at 30 cases per 100.

Tonsil phlegmon predominantly affects young adults between the ages of 20 and 40, although it can develop at any age.

Diagnostic du phlegmon amygdalien

The doctor may suspect tonsil phlegmon by clinical examination. The diagnosis can be confirmed by an intraoral examination. This is a comprehensive examination of the different structures of the oral cavity and oropharynx.

Swelling of the soft palate

The formation of the abscess at the back of the throat causes visible swelling of the soft palate (soft palate). This is located at the back of the mouth in the continuation of the palatal vault (hard palate). 

Fever

The presence of peritoneal phlegmon is accompanied by a relatively high fever (39-40 ° C).

Sore throat

There is intense, unilateral pharyngeal pain, that is, severe pain on one side of the throat.

Otalgie

The pain in the throat can spread to the ear. We are talking about otalgia.

Trismus

It is the involuntary and constant contraction of the muscles of the jaw, which tends to decrease or prevent the opening of the mouth. 

Hypersalivation

The presence of peritoneal phlegmon can cause significant discomfort on swallowing with hypersalivation.

Voice alteration

The voice is veiled. In popular parlance, it is sometimes said to “speak with a hot potato in your mouth”.

Tonsil phlegmon is a medical emergency that may require hospitalization, especially when it occurs in children. Management depends on the stage of development.

Drug treatments

In its simple form, tonsillar phlegmon is treated with antibiotics. Antibiotics are used to fight the infection. Corticosteroids and pain relievers may also be prescribed to decrease inflammation and relieve pain.

Drainage of the abscess

Surgical removal of the abscess is considered in the event of a very large abscess and / or drug treatment failure. Several techniques are possible:

• incision of the abscess;
• removal of the tonsils (tonsillectomy);
• puncture of the abscess with a needle.

The prevention of tonsillar phlegmon is particularly to prevent the development of angina. For this, it is particularly advisable to wash your hands regularly with soap and water.

It is also possible to fight against certain preventable risk factors for tonsillar phlegmon. It is particularly advisable to maintain good oral hygiene, not to smoke or to stop smoking.