Peritonsillar Abscess (Quinsy)
This page was last updated on: August 1, 2012
Early Left Peritonsillar Abscess
Swelling, redness and protrusion of the left tonsil which is covered with white exudate.  The uvula is slightly displaced to the opposite side
Right Peritonsillar Abscess
The swelling around the right tonsil is more evident and so is the displacement of the uvula.
On this axial CT scan, there is narrowing of the airway from an advanced right peritonsillar abscess.
CLINICAL PICTURE

The clinical picture is that of a rapidly increasing difficulty in swallowing that ocurs after a streptococcal tonsillitis (strep throat).   The tonsillitis may seem to be improving for a day or two, but then, one side of the throat becomes increasingly painful. The pain is severe and radiates to the ear.  Opening the mouth is difficult and so painful that the patient refuses to eat or swallow.  There is drooling of saliva and bad breath.  The voice is indistinct and muffled It is referred to as "hot potato speech".

On examination, there is a tense swelling of the soft palate and anterior pillar above the tonsil. The uvula may be displaced to the opposite side.

It is often difficult to know at first whether the swelling is an abscess or a peritonsillar cellulitis. Finally, when the abscess points in the region adjacent to the tonsil, it is incised and drained (Click here for pictures of Incision and drainage).

Occasionally, the abscess ruptures spontaneously and foul-smelling thick pus drains through a crater in the anterior pillar.
QUINSY

Quinsy is an old term synonymous with peritonsillar abscess.  It is derived from the Latin word cynanche meaning sore throat.

George Washington died on December 14, 1799 of a severe throat infection diagnosed by his doctors as quinsy.
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Early Left Peritonsillar Abscess
Swelling and erythema above the left tonsil.  The uvula is slightly swollen as well. Compare to the right peritonsillar area which looks normal.

Otolaryngology Houston

Bechara Y. Ghorayeb, MD
OTOLARYNGOLOGY - HEAD & NECK SURGERY
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Houston, Texas 77043
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