URTI: Peritonsillar Abscesses (aka Quinsy)

Question 1

What is a Peritonsillar Abscess (aka Quinsy)?

Answer 1

Pus collection between Palatine tonsil + Pharyngeal Muscles

Question 2

What is the most common cause of Peritonsillar Abscesses aka Quinsy?

Answer 2

Acute tonsillitis caused by Group A Strep pyogenes (GAS) (most common)

• Acute tonsillitis infection penetrates tonsillar capsulse –> Peritonsillar cellulilitis –> Peritonsillar Abscess (aka Quinsy)

Question 3

What are the CF of Peritonsillar Abscesses (aka Quinsy)? (6 things)

Answer 3

1. Fever + Lethargy
2. Trismus (reflex spasm of the medial pterygoid musc) (most reliable indiciator for Quinsy)
3. Asymmetric tonsillar swelling w uvular displacement (see pic)
4. Dysphonia (aka hoarseness)
5. Sore throat
6. Odynophagia

Question 4

How is the diagnosis for Peritonsillar Abscesses (aka Quinsy) made? (2 things)

Answer 4

1. Mainly Clinical: seeing medially displaced tonsil + uvula deviation
2. Confirmed by pus collection @ drainage

Question 5

What investigations can you do for Peritonsillar Abscesses (aka Quinsy)?

Answer 5

Graim stain of Aspirated fluid

Culture Aspirated fluid

Throat culture

Gram stain and culture of aspirated fluid and throat culture aids in identifying causative pathogens for targeted antibiotic therapy.

Question 6

When should you do a CT for Peritonsillar Abscesses (aka Quinsy)?

Answer 6

If infection sus spread to deeper parts

Question 7

What are the management options for Peritonsillar Abscesses (aka Quinsy)? (4 things)

Answer 7

1. Airway management by intubation (if airway obst)
2. Incision + Drainage (under general) (by ENT Dr)
3. Abx (Amoxicillin)
4. Tonsillectomy (if recurrent / airway obst)

Question 8

What are the complications of Peritonsillar Abscesses (aka Quinsy)? (5 things)

Answer 8

1. Airway obst
2. Retropharnygeal Abscesses
3. Pneumonia
4. Cellulilitis of Head n Neck
5. Sepsis