Quinsy, also known as a peritonsillar abscess, is a serious bacterial infection forming a pus-filled pocket near one of the tonsils. This condition is considered a medical emergency requiring prompt medical intervention.
What is Quinsy
Quinsy refers to a peritonsillar abscess, an accumulation of pus that develops behind or next to one of the tonsils. This abscess forms in the peritonsillar space, an area of loose connective tissue located between the tonsillar capsule and the superior constrictor muscle of the pharynx. An infection in the tonsil can spread into this peritonsillar space, leading to the formation of the abscess.
Common Symptoms
Individuals experiencing quinsy often report a severe sore throat that typically worsens rapidly and is usually more pronounced on one side of the throat. Difficulty swallowing, known as dysphagia, is a prominent symptom, often leading to drooling because it becomes too painful to swallow saliva. This can also cause a muffled or “hot potato” voice, a distinctive change in speech quality due to swelling in the throat.
Other common signs include fever and chills. Many people also experience ear pain on the side of the affected tonsil, along with swelling in the face and neck. A limited ability to open the mouth, known as trismus, is another frequent and telling symptom, resulting from inflammation of the muscles involved in chewing.
Causes of Quinsy
Quinsy typically develops as a complication of an untreated or partially treated bacterial tonsillitis. The most common bacteria responsible is Streptococcus pyogenes, also known as Group A Strep, which is the same bacterium that causes strep throat. The infection spreads from the tonsil into the peritonsillar space, where it leads to pus formation.
While bacterial infection is the primary cause, other factors can increase the likelihood of developing quinsy. Chronic tonsillitis, which involves repeated or persistent inflammation of the tonsils, can predispose an individual to this condition. Smoking and certain oral infections may also contribute to the risk.
Diagnosis and Treatment
Diagnosing quinsy primarily involves a physical examination of the throat, where a healthcare provider looks for characteristic unilateral swelling, often with the uvula (the small fleshy hanging ball at the back of the throat) pushed away from the affected side. In some cases, imaging tests like a CT scan or ultrasound may be used to confirm the diagnosis, especially if there’s uncertainty or concern about the infection spreading deeper.
Treatment for quinsy typically involves a combination of procedures and medications. Draining the pus from the abscess provides immediate relief and is performed either by needle aspiration or by making a small incision. Needle aspiration uses a syringe to draw out the pus, while incision and drainage involves a small cut to allow the pus to flow out. Both methods are usually done under local anesthetic.
Antibiotics are prescribed to clear the underlying bacterial infection and prevent recurrence. Common antibiotics include penicillin, amoxicillin, and clindamycin, often administered intravenously initially due to difficulty swallowing. Pain relievers are also given to manage discomfort. Maintaining hydration is important, as the pain of swallowing often leads to reduced fluid intake. Prompt medical attention is necessary because untreated quinsy can lead to serious complications, including airway obstruction or the spread of infection to other parts of the body.