Quinsy- a serious complication of tonsillitis
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
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:
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