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

EMKF

Emergency Medicine Kenya Foundation (EMKF) is an NGO supporting emergency healthcare providers across Kenya to save lives by strengthening the emergency healthcare system through capacity building, knowledge development, advocacy and research.