Quinsy

Infection of the tissue surrounding one of the tonsils is called quinsy and is medically known as a peritonsillar abscess.

Last Updated: February 25, 2024

Quinsy is the most common infection of the deep head and neck spaces in the emergency room, with a frequency of about 1 in 10,000. Although it can happen to anyone, it is more prevalent among teenagers.

Quinsy is typically a consequence of tonsillitis caused by bacteria. When the infection in your tonsil spreads to the surrounding tissue, this infection will develop. 

Smoking and gum disease are two risk factors for quinsy.

A sore throat is often the initial sign of quinsy, followed by the appearance of other symptoms over a few days. Symptoms that are prevalent include but are not limited to:

  • Tonsillitis
  • Fever
  • Chills
  • Facial and neck swelling
  • Headache
  • Earache
  • Drooling
  • Trouble swallowing
  • Bad breath
  • Hoarseness
  • Obstructed uvula (the fleshy, hanging ball in the back of your throat) by a tonsil

Quinsy is usually diagnosed by one or more of the following signs:

  • One side of the peritonsillar area swells up
  • Acute tonsillitis that doesn't go away and persistent growth of one tonsil
  • A bulge on one side of the soft palate, with the opposite side's tonsil moving forward.

Doctors may order the following labs:

  • Electrolytes and a complete blood count (CBC)
  • Test for heterophile antibodies (to rule out suspicion of infectious mononucleosis)
  • Pus culture sensitivity from an abscess needle aspirate
  • Patients showing signs of sepsis may need a C-reactive protein blood culture.

Treatment

Most of the time, the abscess must be drained through surgery and treated with antibiotics. If there is more than one abscess, the tonsils may need to be removed.

A doctor will prescribe antibiotics, which can be given intravenously (through a vein) or as pills. Examples of antibiotics are penicillin, amoxicillin, cephalosporin, and clindamycin.

Most of the time, your doctor will drain the peritonsillar abscess. To do this, they will cut the abscess to drain the fluid.

If the abscess becomes recurring, the doctor may suggest taking the tonsils out with a surgical procedure called a tonsillectomy. 

There is no specific way to avoid quinsy. However, one can lower the risk by doing the following:

  • Not smoking
  • Maintaining a high standard of oral hygiene
  • Providing early treatment for oral infections.

 

References

Gupta G, McDowell RH. Peritonsillar Abscess. [Updated 2022 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519520/ 

Cleveland Clinic 2022). Peritonsillar Abscess. Retrieved December 16, 2022, from https://my.clevelandclinic.org/health/diseases/22817-peritonsillar-abscess-quinsy

Last Updated: February 25, 2024