OpenHealth Q&A

🚨Persistent Retropharyngeal Abscess Challenge 🚨

I’m reaching out to this community in hopes of finding insight or shared experiences regarding my ongoing health struggle, as this has been debilitating for several months now, preventing me from working and contributing to my overall sense of malaise. I’m a 21-year-old female. It all began with a sore throat on Wednesday, April 2nd, which felt similar to typical tonsil pain. By that Friday, I discovered a white pus-filled lesion on one of my tonsils that made swallowing excruciatingly painful. I consulted with a Telehealth doctor who prescribed antibiotics, assuming it was tonsillitis. On Saturday, April 5th, I managed to remove the white mass—it was soft—and shortly after, the pain escalated dramatically, radiating deeply into my neck. Swallowing became nearly impossible, prompting me to visit an after-hours clinic. There, the physician informed me that the initial antibiotics were inappropriate for tonsillitis, prescribed a different course, and reassured me that the discomfort should subside within a couple of days. Additionally, I was given codeine for the pain, which proved ineffective. As the agony continued to intensify, I became so distressed by April 8th that I sought urgent care at the hospital due to severe pain and dehydration. They administered three bags of IV fluids, along with pain relief, before transferring me to a ward. That night, they discharged me with the assurance that it was merely tonsillitis and that the prescribed antibiotics would clear the issue. My hsCRP level was recorded at 149. However, later that evening, my pain returned, leading me to schedule an appointment with my GP for the following day. At my GP visit on April 9th, I was in such discomfort that I struggled to move my neck and communicate. He swiftly referred me for a CT scan as I felt intense pressure in my throat, almost as if my ear might burst. The CT scan revealed a pharyngeal abscess (measuring 19x31x32mm), and my GP instructed me to return to the hospital where I was again fast-tracked into the emergency department. An ENT specialist performed a scope and recommended postponing surgical intervention until the next morning, opting instead to administer antibiotics overnight to reduce the size of the abscess. During our discussion with an ICU doctor, the abscess unexpectedly ruptured, causing me to expel a foul-smelling pus for two hours before I was moved to the ICU. I remained hospitalized for several days, receiving intravenous antibiotics before being discharged with oral antibiotics. I expressed my concerns about ongoing pain during swallowing, yet the ENT could not provide an explanation. In the weeks following the rupture, I frequently experienced a sensation that food was becoming lodged in my throat during swallowing, requiring me to wash down each bite with water. By late April, when my severe pain resurfaced, I consulted a different GP due to the weekend situation. They provided me with yet another round of antibiotics similar to the ones I had after my hospital visit and ordered blood tests to monitor my infection levels. On May 2nd, I developed troubling cold-like symptoms, which cleared up by the next day, but were followed by the reappearance of white spots on my tonsil that eventually faded after a few days. I had a follow-up appointment with an ENT on May 16th, where I relayed my continued difficulties with swallowing. Unfortunately, they could not identify a specific cause and even after pushing for a more thorough scope, they concluded that everything appeared normal and could not offer further assistance. Despite being discharged, I continued to endure significant discomfort during swallowing for approximately two months. This eventually evolved into alternating pain in my tonsils every few days, culminating in a resurgence of deep neck pain by the end of July. On August 5th, my GP suspected it wasn’t the same issue and opted for an ultrasound instead of a CT scan, due to concerns about radiation. After completing the ultrasound, the technician consulted with a physician who insisted on a CT scan; the results indicated inflammation in the location of my previous abscess, but without any pus present. Consequently, my GP initiated a course of steroids and later contacted me to discuss starting another round of antibiotics based on his review of the scan. Despite revisiting my GP on the 11th with persistent pain, I was prescribed additional antibiotics and referred to another ENT, who was unhelpful. Then, I saw a different ENT who seemed promising in evaluating my condition, starting me on even more antibiotics. The experience has been incredibly bewildering, with inconsistent advice from various medical professionals. Since my discharge in April, I’ve suffered from numerous colds, a severe sinus infection, a stomach bug post-scope, chronic fatigue, and I’ve been unable to work. It’s important to note that I’ve never before had issues with my tonsils or throat, leading me to suspect they are not the underlying cause of my ongoing discomfort.

Answers (1)

8/27/2025, 12:24:32 PM

OpenHealth AI

I’m really sorry to hear about the intense and prolonged difficulties you’re experiencing. It sounds incredibly frustrating and exhausting. Your health challenges with the retropharyngeal abscess and subsequent issues have understandably caused significant distress. It's important to focus on identifying the underlying cause for your ongoing symptoms and finding effective management strategies.

Summary of the Situation:

• You’ve had a history of severe pain, swallowing difficulties due to a pharyngeal abscess, and inconsistent medical care.
• Multiple courses of antibiotics have been prescribed, yet you continue to experience throat pain and additional illnesses.
• You are seeking clarity and a path forward, particularly since this has affected your quality of life and ability to work.

Explanation:

After experiencing a retropharyngeal abscess, which can lead to significant swelling and inflammation in the throat, it's common to have lingering symptoms such as pain or discomfort while swallowing. Even after the abscess has resolved, the surrounding tissues can remain sensitive and inflamed. There may also be secondary issues such as postnasal drip, allergies, or even anxiety about swallowing due to previous pain, which could complicate recovery.

Next Steps:

1. Symptom Diary: Keep a daily diary noting when the throat pain occurs, its intensity, any associated symptoms, and things that seem to trigger or alleviate the pain. This can provide useful information to healthcare professionals.

2. Follow-up with ENT: It might be beneficial to return to an ENT specialist who has experience with post-abscess complications. Ensure they are aware of your complete medical history and express your persistent difficulties clearly. Consider asking about:

   • Potential allergies or sensitivities that could be contributing to your symptoms.
   • A flexible endoscopy or nasopharyngoscopy if you haven't had one recently. This can help visualize any lingering issues in your throat.

3. Manage Pain and Discomfort: You can try some home remedies to help manage pain:

   • Warm saltwater gargles several times a day can soothe the throat.
   • Stay hydrated and consider soft foods, avoiding anything spicy or acid-based that might irritate the throat.

4. Voice Rest: If possible, limit speaking to give your throat time to heal. Avoid whispering, which can strain your voice even more.

5. Consult a Specialist: If you haven’t already, consider seeing a gastroenterologist to check for any issues like acid reflux, which might not be apparent but could exacerbate your throat pain and swallowing difficulties.

6. Mental Health Support: Given this prolonged struggle, it may also be useful to seek support from a mental health professional who can provide coping strategies for dealing with chronic pain and health challenges.

Reminder:

Throughout this process, prioritize clear communication with your doctors and ensure to express the impact of your symptoms on your daily life. Remember, you deserve to receive thorough care, and if one professional is not helpful, it’s okay to seek a second opinion or a specialist who focuses specifically on your symptoms.

Please take care of yourself, and I hope you find relief soon. Let me know if you need additional guidance or resources.