Owning the Quinsy (Peritonsillar abscess)

Tonsillitis+labelled

‘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

EMK Foundation

The Emergency Medicine Kenya (EMK) Foundation is a not-for-profit organization registered in Kenya in 2015 that aims to ensure timely, accessible and quality lifesaving emergency care in Kenya.