Peritonsillar Abscess

Question 1

What is another term for peritonsillar abscess?

Answer 1

Quinsy

Question 2

What is a peritonsillar abscess?

Answer 2

A pus filled pocket near tonsils

Question 3

What is it a common complication of?

Answer 3

Bacterial tonsillitis that has been under treated

Question 4

What symptoms are associated?

Answer 4

Severe throat pain on one side
Drooling
Dysphagia 
Difficulty opening mouth (trismus) 
Halitosis 
Dysphonia - hot potato voice 
Neck pain

Question 5

What signs are associated?

Answer 5

Fever
Peri tonsillar swelling with deviated uvula
Swelling of jugulodigastric nodes
Signs of tonsillitis - red, enlarged and purulent discharge

Question 6

Do all quinsys require drainage?

Answer 6

Yes

Question 7

How is it managed?

Answer 7

Needle aspiration following topical local anaesthetic
OR
Incision and drainage
IV antibiotics
Possibly IV dexamethasone (if wanting to treat the tonsillitis)
Fluids
Pain relief

Consider tonsillectomy in 6 weeks

Question 8

Why must it be treated immediately?

Answer 8

Can lead to airway obstruction

Question 9

What investigations could you consider (although should not impede management)?

Answer 9

FBC
U&E 
CRP
LFT 
Glandular fever screen

Question 10

Should a tonsillectomy be considered?

Answer 10

Yes consider it in 6 weeks - there are strict guidelines for it