Quinsy- a serious complication of tonsillitis

Quinsy- a serious complication of tonsillitis

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Quinsy- a serious complication of tonsillitis

symptoms
who gets it?
causes
treatment
Authored by Dr Richard Bennett on 11.03.2019
Medically Reviewed by Dr Aifric Boylan
Last updated on 12.03.2019

What is Quinsy?

  • Quinsy occurs when an abscess forms at the top of one of the tonsils
  • An abscess is a collection (or bag) of pus
  • The tonsils are the 2 lumps you can see in your throat when you open your mouth wide
    • They sit in the bottom corners at the back (behind your tongue)
    • They are either side of the dangly “uvula” which hangs from the top

quinsy

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What are the symptoms of Quinsy?

  • Worsening sore throat
  • Feeling unwell
  • Significant difficulty swallowing
  • Smelly breath
  • Usually a fever (high temperature)
  • Usually the glands are up in your neck
  • Sometimes earache
  • Sometimes difficulty opening the mouth wide
  • Sometimes it causes you to speak with a strange voice, sounding like you have a golf ball in your mouth

What does Quinsy look like?

  • The tonsil that has the abscess will look large, often pushing the uvula (which normally dangles in the middle) off to one side
  • The uvula itself may look swollen
  • Your mouth may look “yucky” or unclean

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
  • Usually the best antibiotic is Penicillin – an alternative should be given if you’re allergic
  • The abscess should usually be drained 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

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About the Author:

Richard Bennett
Dr Richard Bennett is an experienced UK-qualified GP, based in Melbourne. He attended medical school at Imperial College in London, and subsequently worked at Charing Cross Hospital and Royal Surrey County Hospital, before completing his vocational training in General Practice. For many years he was a GP owner in Norwich, where he was also an Executive Board Member for the Local Health Authority. He is a full time doctor working in a busy Melbourne GP clinic, as well as a founder and director of Qoctor. He is a regular contributor on the topics of migraine and mental health.

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