Quinsy is a common encounter in family physician practice. It is defined as a collection of purulent material in the peritonsillar space, giving appearance of unilateral palatal bulge. Presenting symptoms include trismus, muffled voice, odynophagia, and ipsilateral otalgia. When the diagnostic needle aspiration reveals no pus, the diagnosis is changed into peritonsillar cellulitis or also known as perintonsillitis. Peritonsillitis is sufficiently treated with antibiotics unlike a quinsy which warrants surgical incision and drainage. Acute tonsillitis is a disease in children, whereas peritonsillar cellulitis and abscess are known to affect young adults. Peritonsillar cellulitis is considered as a transition phase of the peritonsillar inflammatory process becoming an abscess or quinsy. It may or may not be related with previous or concurrent tonsillitis. Current review confirms that peritonsillar infection begins with Weber’s gland, a group of mucous salivary glands located in the space just superior to the tonsil in the soft palate.
In one study, 16 52 consecutive patients who had a positive needle aspiration of a peritonsillar abscess were randomized into two groups comparing needle aspiration alone with incision and drainage. A tonsillectomy may be recommended in severe cases of quinsy or if you have recurring bouts of sore throats. Results of this study indicate that male smokers aged 21—40 years are particularly at risk of quinsy. Boston: Little, Brown, Peritonsillar Abscess: Diagnosis and Treatment. The current low doses of antibiotics used in modern community settings may be less likely to protect against quinsy than the trial evidence suggests.
Last updated: May 16, Revisions: Tonsillitis is a common presentation in primary care, most common in children and young adults. Recurrent tonsillitis has an incidence in the UK of around per population a year. A cough and coryzal symptoms may also be present. A purulent exudate may be present more common in bacterial cases, as well as anterior cervical lymphadenopathy. Figure 2 — Tonsillitis. The tonsils are erythematous and swollen, with evidence of exudate. The Centor criteria however is not suitable for emergency presentations and is rarely used in a hospital setting.