Head and Neck A6


Peritonsillar abscess (Quinsy) management

Peritonsillar abscess, commonly known as quinsy, is a collection of pus that develops between the tonsillar capsule and the surrounding superior constrictor muscle. Peritonsillar abscess tends to develop as a complication of acute tonsillitis. 

On examination, there is usually a degree of trismus (inability to fully open the mouth), and the uvula is pushed away from the midline by the swelling under the soft palate. If large, a quinsy may cause airway compromise.

A quinsy requires aspiration or incision and drainage, after which the patient usually feels significantly better. Patients are usually admitted and treated as for severe tonsillitis with IV antibiotics.

If left untreated, peritonsillar abscess may spread resulting in a deep neck space infection, which is an airway emergency. This can be investigated with a CT of the neck with contrast.

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