Who gets Quinsy?

• Quinsy starts during tonsillitis
• It’s commoner in people who get tonsillitis recurrently
• It happens to between 1 and 4 in 10,000 people per year
• Tonsillitis is when your tonsils become swollen, inflamed and painful
  • This is usually caused by bacteria or viruses
• People with tonsillitis can therefore progress to developing quinsy
• Anybody can develop quinsy. Certain people are more likely to get it:
  • People on immune-suppressing medications
  • People with illnesses affecting the  immune system (eg. HIV)
  • People with diabetes
  • Smokers
  • People with poor dental health (bad teeth/gums) – (1, 2)

What causes Quinsy?

• Bacteria responsible for tonsillitis (usually Streptococcus or Haemophilus species) form an abscess on a tonsil
• It’s not known why this happens

What is the treatment for Quinsy?

• You need to go to hospital urgently, as it’s important that quinsy is treated before it affects your breathing
• Antibiotics given intravenously (in a drip, usually into your arm)
• You’ll usually be given intravenous fluids as well (for dehydration)
• Sometimes steroids are given – these have been shown to help
• The abscess will usually be drained by a doctor, using a scalpel (sharp surgical knife) or a needle
  • Usually the area is numbed first using a spray
  • Some people have a general anaesthetic for this (surgery after being put to sleep)

Can I die of Quinsy?

• Yes, though this extremely rare if you are treated in hospital
• Outcomes are usually excellent if the right treatments are given

What’s the prognosis for Quinsy?

• Outcomes are generally very good
• You usually need to have your tonsils surgically removed (tonsillectomy) a few weeks after you’ve recovered to prevent it from happening again

Article Resources

1 Geißler K et al Functional characterization of T-cells from palatine tonsils in patients with chronic tonsillitis

2 Wikstén J at al Renewal of peritonsillar abscess: Impact of the bacterial species of the infection and clinical features of the patient-A prospective comparative aetiological study

Tonsillar abscess (Quinsy)

• Tonsillar abscess (also known as “Quinsy” ) is a possible complication of tonsillitis.
• An abscess containing pus forms near the infected tonsil, often leading to severe pain and swelling, as well as fevers and chills.
• The pain will usually be worse on one side of the throat. Quinsy can be so painful that a person cannot swallow their own saliva, which can lead to drooling.
• It may be hard to open the mouth and quite difficult to speak.
• It’s a serious condition and usually requires treatment in hospital, which may involve intravenous antibiotics and surgical drainage of the abscess.

Tonsil stones  (Tonsilloliths)

• Also known as tonsilloliths, these are small hard white or yellow deposits that occur on the tonsils.
• They can be formed from a build up of food particles, mucus, calcium and dead cells- and tend to build up in the natural hollow on the surface of the tonsil.
• Quite often they cause no problems and may just be noticed when looking into the mouth.
• Sometimes they lead to bad breath (halitosis) or discomfort.
• They may be prevented by good oral and dental hygiene, not smoking, and staying well hydrated.
• It’s not recommended to remove stones yourself- if you’re having a lot of trouble with them, it may be worth speaking to your doctor.

Tonsillar Hypertrophy (enlarged tonsils)

• Tonsillar Hypertrophy means persistently enlarged tonsils.
• Some people have naturally large tonsils, and it causes no symptoms or complications. For others, large tonsils can be a sign of infection, irritation or allergy.
• Tonsillar Hypertrophy is very common in children, but most of the time there is no need to do anything about it as the problem often goes away over time.
• However, if there is recurrent tonsillitis, mouth breathing, bad snoring, sleep apnoea or glue ear, sometimes a tonsillectomy may be considered.
• Obviously if there are any underlying triggers such allergies, these should be addressed first.

What is the treatment for enlarged adenoids?

• Often no treatment is needed as they start to shrink when a child is over 5 years old.
• Steroid nasal sprays may help hay fever/allergic rhinitis and thus reduce the size of the adenoids
• Surgery is sometimes needed

When do adenoids need to be removed?

• As adenoids naturally shrink and disappear during early childhood, in most cases, no surgery is needed.
• However if a child is experiencing significant ongoing health problems due to their adenoids, such as obstructive sleep apnoea or recurrent middle ear infections, surgery may be considered.
• Your GP may refer you to an Ear, Nose and Throat specialist. They may pass a camera into the back of the throat to take a look at the adenoids to find out how big the adenoids are, and if surgery is likely to help.

If you have further questions about your child’s adenoids, speak to your GP. You can also read more about Obstructive Sleep Apnoea (OSA) in children at the Royal Children’s Hospital website.