Quinsy

Question 1

What is the most common cause of quinsy?

Answer 1

Streptococcus pyogenes

Question 2

List other pathogens that can cause quinsy.

Answer 2

• Staphylococcus aureus
• Haemophilus influenzae
• Streptococcus anginosus
• Viridans streptococci

Question 3

What are the clinical features of quinsy?

Answer 3

• Features of tonsillitis: fever, malaise, severe sore throat, dysphagia, and odynophagia
• Muffled speech, drooling, halitosis
• Trismus (difficulty opening mouth)
• Uvula shifted to unaffected side, with inferior and medial displacement of tonsil
• Unilateral fluctuant, swollen, erythematous tonsil with exudates
• Ipsilateral cervical lymphadenopathy

Question 4

If a patient with suspected quinsy comes into GP, how should they be managed?

Answer 4

Urgent referral to ENT

Question 5

How is quinsy usually managed by ENT specialists?

Answer 5

• Incision and drainage under GA
• Broad-spectrum abx (co-amoxiclav) before and after surgery
• Steroids (dexamethasone) to settle inflammation and help recovery