Owning the Quinsy (Peritonsillar abscess)


‘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

Emergency Medicine Kenya Foundation