OpenHealth Q&A

Is Swelling and Pain After Peritonsillar Abscess Drainage Expected Within 24 Hours?

Hello everyone, I'm reaching out for some insights. I’m a 34-year-old woman, standing at 5'3" and weighing 140 pounds. Typically, I don’t take medication, but in the last fortnight, I’ve encountered several prescriptions due to a rough time healthwise, detailed below: I might be a bit overly cautious sharing here, but it has been a tumultuous couple of weeks, and I would really value some advice. On June 13, I visited urgent care because I was experiencing a mild sore throat that had persisted for about a week, accompanied by noticeable swelling and white spots on my right tonsil. The physician's assistant suggested the issues were likely due to tonsil stones. She attempted to remove them with no success and advised me to try doing it at home while prescribing chlorhexidine mouthwash. In my attempts to extract the “stones” myself, I accidentally caused bleeding. I continued using the mouthwash for about a week, but by the end of that period, I observed that the once localized white spots were now more widespread across the tonsils, with the other one developing similar marks. I returned to urgent care on June 21. This time, the PA noted signs of infection, but given the negative rapid strep test, he was uncertain about the exact cause. He prescribed azithromycin. Unfortunately, my condition deteriorated daily while on azithromycin, with escalating swelling and pain, prompting a visit to the ER on June 24 due to inadequate support from urgent care. At the emergency room, I was informed that my situation appeared to be typical tonsillitis and that azithromycin was not the appropriate treatment; clindamycin was suggested instead. The staff administered that along with a single dose of dexamethasone (8 mg total) to help reduce the swelling. They also arranged for an ENT consultation on June 25 and performed a blood test to rule out mono. However, that night my situation grew worse. When I saw the ENT on June 25, she indicated that while there were no obvious signs of an abscess, the ER’s choice of medication was incorrect, and I should have been prescribed clarithromycin instead of clindamycin (considering my childhood allergy to amoxicillin, which an allergist will assess next month). She recommended switching to clarithromycin if there were no improvements by June 26, and she took another throat swab for culture, with results expected soon. Later that day, I experienced a significant increase in swelling on the affected side of my face and neck. It became increasingly difficult to breathe, talk, and even swallow liquids, which led me back to the ER. They conducted a CT scan that revealed an abscess, which they drained twice, provided an IV antibiotic, and administered another steroid. They advised me to see the ENT the following morning. I felt better this morning compared to the previous days, switched to clarithromycin as recommended, and revisited the ENT. She wanted to ensure complete drainage of the abscess, so she administered local anesthesia and attempted to drain it again twice, though she was unable to extract more pus. Now, a few hours later, I find myself in significant pain again, and the swelling in my face and neck has returned. Given all of this, I presume I know the likely answer, but I seek reassurance after everything: Should this discomfort and swelling be expected following multiple needle insertions in my tonsil? Is it safe for me to consider this a normal part of recovery? I truly appreciate any guidance you might provide!

Answers (1)

6/26/2025, 9:10:51 PM

OpenHealth AI

It’s completely understandable to feel anxious about pain and swelling after experiencing a peritonsillar abscess and its drainage. Swelling and discomfort in the area post-drainage can indeed occur, as your body is reacting to both the infection and the procedure itself. Here are the main points to consider:

Key Takeaways:

1. Post-Drainage Symptoms: It’s not uncommon to experience increased swelling and discomfort after the drainage of a peritonsillar abscess. This can happen due to irritation from the procedure and ongoing inflammation from the infection.

2. Recovery Expectations: You may notice various fluctuations in your symptoms as your body heals. However, if symptoms significantly worsen or new symptoms arise, further evaluation may be necessary.

Explanation:

After the drainage, your tissue is inflamed and recovering, which can lead to temporary increases in pain and swelling. The area is sensitive and can react not only to the infection but also to the multiple interventions. While discomfort is expected, particularly within the first 24 to 48 hours post-procedure, observe your symptoms carefully.

Recommended Steps:

1. Manage Pain: Take over-the-counter pain relievers as advised by your healthcare provider to manage pain effectively. Ensure you follow any recommended dosage.

2. Stay Hydrated: Drink plenty of fluids, as adequate hydration can support healing and help soothe your throat. Opt for warm teas or broths, which might also be more comforting.

3. Monitor Symptoms: Keep a close watch on your symptoms. If you experience sharp increases in swelling, difficulty breathing or swallowing, or any rash, seek medical attention immediately.

4. Follow Up with Your ENT: Make sure to attend your follow-up appointments so that your ENT can monitor your recovery and assess if any additional treatments are needed.

5. Rest and Recovery: Prioritize rest as your body heals. Avoid talking too much or straining your throat to allow it to recover.

When to Seek Help:

If your pain escalates beyond what you've experienced, if you develop a fever, or if you notice any new concerning symptoms, don’t hesitate to reach out for further medical evaluation.

It's completely normal to seek reassurance after such a challenging health issue, and you are not alone in feeling this way. Your healthcare team is there to help and can provide the necessary support as you recover.