‘Good’ symptoms for quinsy include:

• ‘Thick’ or ‘hot potato’ voice (not hoarse, croaky voice)
• Stertor
• Trismus
• Inability to swallow more than saliva or a sip or water
• Pain much worse on one side than the other (+/- otalgia)

To differentiate it from tonsillitis, a quinsy will have many of the following signs:

• There is usually a degree of trismus
• On the affected side, the anterior arch will be pushed medially
• On the affected side, the palate will bulge towards you ie the normally concave palate becomes convex
• The uvula may or may not be pushed away from the affected side
• On the affected side, the mucosa of the arch and palate may look angrily erythematous

A swollen tonsil is NOT a quinsy; a swollen tonsil is a swollen tonsil

How to drain a peritonsillar abscess in the ED…it’s not rocket science and your patient will love you for the pain relief