Peritonsillar abscess(Quinsy)


It is a collection of pus in the peritonsillar space which lies between the capsule of tonsil and the superior constrictor muscle.

Peritonsillar abscess usually follows acute tonsillitis though it may arise de Novo without previous history of sore throats. First,one of the tonsillar crypts,usually crypta magna gets infected and sealed off.It forms an intratonsillar abscess which then bursts through the tonsillar capsule to set up peritonsillitis and then an abscess.

Organisms involved: culture of the pus from the abscess may reveal pure growth of S.pyogenes,S.aureus,or anaerobic organisms.

Clinical features

Peritonsillar abscess mostly affects adults and rarely the children though acute tonsillitis is more common in children. usually it us unilateral though occasionally bilateral abscesses are recorded.

Clinical features are divided into ;

  • General: They include fever,chills ,rigor,general malaise, body aches,headache, nausea and constipation.
  • Local: Severe pain in throat,odynophagia,hot potato voice,foul breath,ipsilateral earache,trismus

Examination:


  • The tonsil,pillars and soft palate on the involved side are congested and swollen
  • Uvula is swollen and oedematous and pushed to opposite side
  • Bulging of the soft palate and anterior pillar above the tonsil
  • Mucopus may be seen covering the tonsillar region
  • Torticollis
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