Quinsy, which is also known as peritonsillar abscess, is an infection that begins in the region of the tonsils that are located on either side of a teen’s upper throat. Quinsy is different from tonsillitis in that the infection is more serious with potentially devastating or fatal consequences if spread occurs to the surrounding structures. This is the most common infection of the deep neck space and it typically occurs in adolescents and young adults. Relative to tonsillitis and sore throat, however, Quinsy is uncommon.
This type of infection usually has a bacterial cause such as the Streptococcus or the Staphylococcus although other bacteria have been implicated. Quinsy typically affects only one of the two tonsils. Because Quinsy involves an abscess or collection of pus, the abscess could rupture spontaneously into the teen’s throat. In that case, the teen could breathe the pus into his or her lungs causing complications including aspiration pneumonia.
Who is likely to develop Quinsy?
Teens who develop Quinsy typically have a history of tonsillitis that develops into an abscess, the collection of pus. Unlike tonsillitis, which may occur in all age groups but especially among younger adolescents and children, the average age of patients who develop Quinsy is approximately fifteen years. Quinsy is rare in children.
What are the symptoms of Quinsy?
Adolescents often have a history of sore throat with pain that may be more prominent on one side. There may be malaise, fever, chills, ear pain, difficulty in swallowing and some inability to open the mouth. Teens may also have a muffled or “hot potato” voice. When this occurs, they speak in indistinct manner much like the sounds an individual makes when he or she is trying to talk with a very hot piece of food in the mouth.
The teen with Quinsy has enlarged tonsils, but one is usually larger than the other due to the presence of the abscess. Because the teen may have difficulty swallowing, he or she may also be drooling saliva that has collected in the mouth. The breath often has a foul odor from the infection and possibly due also to dehydration. Adolescents with mononucleosis may have some symptoms that are similar to Quinsy; however, Quinsy usually occurs more abruptly and the patient’s symptoms are more severe.
How is Quinsy evaluated?
Teens with the symptoms of Quinsy should see a physician on an emergency basis. If Quinsy is suspected, the physician usually attempts to draw out the pus from the tonsillar abscess using a needle. Needle aspiration is usually the best way to diagnose Quinsy, and will also initiate the patient’s recovery. The aspirated material can then be sent to the laboratory for bacterial culture.
How is Quinsy treated?
After needle aspiration, the adolescent is started on antibiotic treatment. Although most teens can be managed on an outpatient basis using oral antibiotics, some are admitted to the hospital for treatment with intravenous antibiotics. This may be necessitated by the need in certain cases for the patient to have surgical drainage of the abscess. In some teens, a tonsillectomy procedure may be performed. The surgeon may elect also to remove both tonsils.
How is Quinsy prevented?
There is no specific prevention for Quinsy. If a teen has a persistent sore throat accompanied by fever or unusual pain, a clinician should see him or her. Since some cases of Quinsy are due to the Streptococcus, early treat of Strep throat could help to prevent Quinsy.
Related topics:
Antibiotics, mononucleosis, strep throat
