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Information for patients with tonsillitis and quinsy - an infection and inflammation of the tonsils and an abscess or a pus build up on your tonsil.
What is quinsy? It is an abscess or a pus build up on your tonsil. It usually only occurs on one side and can occur after having tonsillitis. A fully developed abscess requires you to be admitted in hospital, where antibiotics are given through a drip. They may also need to drain the pus under local anaesthetic spray. How are they treated?
What is quinsy? at forms near one of your tonsils. It’s usually a complication of tonsillitis. but this isn’t always the case. It is often caused by the sam. Signs and symptoms. Sore throat. Fever/ chills. Swelling of your face and neck. Head or earaches. Drooling and dificulty swallowing.
- Introduction
- Aetiology
- Risk Factors
- Clinical Features
- Differential Diagnoses
- Investigations
- Diagnosis
- Management
- Complications
- References
A peritonsillar abscess (also known as quinsy) is a complication of acute tonsillitisin which pus collects in the peritonsillar space. If untreated it may lead to deep neck space infection. Quinsy affects around 12 per 100,000 people in England.1
Peritonsillar abscesses are a complication of acute tonsillitis. The palatine tonsils are bilateral lymphatic tissue in the oropharynx that make up part of Waldeyer’s ring along with the adenoids, bilateral tubal tonsils and lingual tonsil. A peritonsillar abscess collectslateral to the palatine tonsils in the peritonsillar space. This is a potenti...
The main risk factor for developing a peritonsillar abscess is recurrenttonsillitis. Other risk factors include: 1. Age: teenagers/young adults are more likely to develop a peritonsillar abscess 2. Male sex 3. Smoking
History
Typical symptomsof a peritonsillar abscess include: 1. Sore throat: particularly on swallowing (odynophagia), typically worse on one side (may have referred pain to the ear – a.k.a. otalgia) 2. Change in voice: commonly described as ‘hot potato voice’, but not hoarseness 3. An inability to swallow: this may be limited to saliva or small sips of liquid
Clinical examination
Typical clinical findings in the context of peritonsillar abscess include:1 1. Trismus: inability or difficulty in opening the mouth fully (defined as opening <3cm) 2. Bulging palatine arch on the affected side: with uvula deviation away from the affected side (Figure 1) 3. Signs of sepsis: altered mental state, fever, tachypnoea, tachycardia and hypotension A unilaterally swollen palatine tonsil, or bilateral swollen tonsils (Figure 2), does not indicate a peritonsillar abscess. This is a co...
Differential diagnosesto consider include: 1. Acute tonsillitis 2. Epiglottitis: severe throat pain, fever, hoarse voice and/or stridor 3. Para- or retro-pharyngeal abscess: can be similar in presentation to epiglottitis, may have aphagia or severe dysphagia and sudden voice change. Patients often have stiffness or reduced range of motion of the ne...
Peritonsillar abscess is a clinical diagnosis, however, the following investigations may be considered.
The Liverpool Peritonsillar Abscess (LPS) score is a decision aid for patients with suspected peritonsillar abscesses.1 The LPS has since been adjusted during the COVID-19 pandemic to remove the need for an oral examination. The criteria are as follows: 1. Unilateral sore throat – 3 points 2. Trismus – 2 points 3. Male gender – 1 point 4. Hot potat...
In patients with a suspected peritonsillar abscess, an ABCDE approachshould be adopted during the initial assessment. Airway problems are rare in patients with quinsy, however, those with large abscesses may develop stertor. If there is concern regarding airway compromise, a senior ENT surgeon should be involved. Stridor is very unlikelyand would u...
Complicationsof quinsy include: 1. Retro- and parapharyngeal abscess: deep neck space infections are an airway emergency and can develop from untreated quinsy. Senior members of the ENT team should be involved immediately. Deep neck space infections often need drainage of the collection under general anaesthetic. If not managed promptly, it can lea...
Lau AS, Selwyn DM, Yang D, et al. The Liverpool Peritonsillar abscess Score: Development of a predictive score through a prospective multicentre observational study. Clin Otolaryngol. 2019; 44:293-...Scottish Intercollegiate Guidelines Network. Management of sore throat and indications for tonsillectomy: A national clinical guideline. SIGN; 2010 (SIGN 117). Available from: [LINK]James Heilman, MD (Own work). A right sided peritonsillar abscess. Licence: [CC BY-SA]. Available from: [LINK]Madonella (Own Work). akute bilaterare Tonsillitis. Licence: [CC BY-SA]. Available from: [LINK]Jan 1, 2018 · Quinsy is a complication of acute tonsillitis, usually due to streptococcal infection. It is a collection of pus arising outside the capsule of the tonsil in close relationship to its upper pole. An article from the ear, nose and throat section of GPnotebook: Quinsy.
A peritonsillar abscess is a pus-filled pocket that forms near one of your tonsils. It’s usually a complication of tonsillitis and is often caused by the same bacteria that cause strep throat. Symptoms include severe pain, swollen tonsils and swollen lymph nodes. Treatments include needle aspiration and tonsillectomy.
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Signs and symptoms. Symptoms of quinsy can include: a severe and quickly worsening sore throat, usually on one side. swelling inside the mouth and throat. difficulty opening your mouth. pain...
