Quinsy

Question 1

Quinsy

Answer 1

Peritonsillar abscess

Question 2

Pathophysiology of quinsy

Answer 2

Bacterial infection with trapped pus, forming an abscess in the region of the tonsils

Question 3

Presentation of quinsy

Answer 3

Sore throat

Painful swallowing - dysphagia

Fever

Neck pain

Referred ear pain

Swollen tender lymph nodes

Hot potato voice

Trismus - can’t open mouth

Question 4

Specific symptoms associated with quinsy

Answer 4

Trismus - patient is unable to open their mouth

Hot potato voice - change in voice due to the pharyngeal swelling

Swelling and erythema in the area beside the tonsils

Question 5

Causative organism of quinsy

Answer 5

Most commonly - streptococcus pyogenes (group A strep)

Also:

• staphylococcus aureus
• haemophilus influenzae

Question 6

Investigations for quinsy

Answer 6

Mouth examination

Bloods - CRP

Question 7

Management of quinsy

Answer 7

Referral to ENT for incision and drainage of the abscess under general anaesthetic

Co-amoxiclav before and after surgery

Optional steroids to settle inflammation

Analgesia

Fluids if dehydrated