Overview
Quinsy, also known as a peritonsillar abscess, is a severe complication of tonsillitis where pus collects between the tonsil and the wall of the throat. This condition can cause significant pain and swelling, leading to difficulty swallowing, speaking, and even breathing. It is a medical emergency that requires prompt treatment to prevent further complications. If you think you have quinsy, you should go immediately to an emergency department.
Symptoms:
- Severe sore throat, typically on one side
- Swelling and redness of the throat
- Painful swallowing (odynophagia)
- Difficulty opening the mouth (trismus)
- Muffled or “hot potato” voice
- Fever and chills
- Swollen lymph nodes in the neck
- Ear pain on the affected side
- Drooling or inability to swallow saliva
Causes:
Quinsy often develops as a complication of untreated or severe tonsillitis. The infection can spread from the tonsil to the surrounding tissue, leading to the formation of an abscess. Streptococcus pyogenes, the bacterium that causes strep throat, is commonly involved. Other risk factors include chronic tonsillitis, smoking, and a weakened immune system.
Diagnosis:
Diagnosis is based on a physical examination and patient history. The doctor may observe the swelling and redness in the throat and check for signs of an abscess. In some cases, imaging tests such as ultrasound or CT scans may be used to assess the extent of the abscess. A needle aspiration may also be performed to confirm the diagnosis by extracting pus from the abscess.
Treatment:
- Drainage: The primary treatment for quinsy is to drain the abscess. This can be done using a needle (aspiration) or by making a small incision to allow the pus to drain.
- Antibiotics: Broad-spectrum antibiotics are prescribed to treat the underlying infection and prevent the spread of bacteria. Common antibiotics include penicillin or clindamycin.
- Pain Management: Over-the-counter pain relievers such as paracetamol or ibuprofen can help manage pain and reduce fever.
- Hydration and Nutrition: Maintaining hydration and nutrition can be challenging due to pain and difficulty swallowing. Intravenous fluids may be necessary in severe cases.
Complications:
If left untreated, quinsy can lead to serious complications, including:
- Airway obstruction
- Spread of infection to the neck and chest
- Sepsis (a life-threatening infection spread throughout the body)
- Recurrence of abscesses
Prevention:
Preventing quinsy involves prompt and adequate treatment of tonsillitis to prevent the spread of infection. This includes completing the full course of antibiotics for bacterial tonsillitis and seeking medical attention for severe or recurrent throat infections. Good oral hygiene and avoiding smoking can also help reduce the risk.
When to Seek Medical Attention:
- Severe throat pain that worsens or does not improve
- Difficulty breathing or swallowing
- High fever and chills
- Swelling in the neck or mouth
- Trismus (difficulty opening the mouth)
