Summary about Disease
Quinsy, also known as peritonsillar abscess (PTA), is a complication of tonsillitis where a pus-filled pocket (abscess) forms behind one of the tonsils. It is a relatively rare but serious infection requiring prompt treatment.
Symptoms
Severe sore throat, usually on one side
Difficulty swallowing (dysphagia)
Pain when swallowing (odynophagia)
Fever
Voice changes (hot potato voice - muffled speech)
Difficulty opening the mouth fully (trismus)
Swelling in the neck or face
Ear pain on the same side as the sore throat
Drooling
Causes
Quinsy is typically caused by a bacterial infection that spreads from the tonsils to the surrounding tissue. The bacteria most commonly involved are Streptococcus pyogenes (group A strep), *Staphylococcus aureus*, and *Haemophilus influenzae*. It usually arises as a complication of untreated or inadequately treated tonsillitis.
Medicine Used
Antibiotics: Broad-spectrum antibiotics are administered to combat the bacterial infection. Common examples include penicillin, clindamycin, and cephalosporins.
Pain Relief: Pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help manage pain and fever.
Corticosteroids: Sometimes, corticosteroids like dexamethasone are prescribed to reduce inflammation and swelling.
Is Communicable
Quinsy itself is not directly communicable. However, the underlying tonsillitis or the bacterial infection causing it can be contagious. The bacteria can spread through respiratory droplets (coughing, sneezing, talking).
Precautions
Good Hygiene: Wash hands frequently with soap and water.
Avoid Sharing: Do not share utensils, drinks, or personal items with others, especially if they have a sore throat or cold.
Cover Coughs and Sneezes: Use a tissue to cover your mouth and nose when coughing or sneezing, and dispose of the tissue properly.
Complete Antibiotic Course: If prescribed antibiotics, take the full course as directed by your doctor.
Avoid Close Contact: Limit close contact with others when symptomatic.
How long does an outbreak last?
Without treatment, quinsy can persist for several days to weeks, potentially leading to severe complications. With prompt and appropriate treatment (antibiotics and drainage of the abscess), symptoms typically improve within 24-48 hours, and complete resolution occurs within 1-2 weeks.
How is it diagnosed?
Physical Examination: A doctor will examine the throat, looking for swelling, redness, and signs of an abscess (bulging area).
Medical History: The doctor will ask about symptoms and medical history, especially regarding recent sore throats or tonsillitis.
Needle Aspiration/Incision and Drainage: A needle aspiration or incision and drainage may be performed to confirm the presence of pus and to relieve pressure. A sample of the pus may be sent to a lab for culture to identify the specific bacteria involved.
Imaging Studies (rarely): In some cases, a CT scan or MRI may be used to assess the extent of the infection, especially if there are concerns about deep neck space involvement.
Timeline of Symptoms
Initial Stage (Days 1-2): Sore throat, often starting on one side.
Progression (Days 3-5): Increasing pain, difficulty swallowing, fever, and development of other symptoms like ear pain and voice changes.
Abscess Formation (Days 5-7): The abscess forms, leading to severe pain, trismus, and difficulty opening the mouth.
With Treatment (After Treatment Begins): Improvement in symptoms within 24-48 hours, with gradual resolution over 1-2 weeks.
Important Considerations
Airway Obstruction: Quinsy can cause airway obstruction due to swelling. Seek immediate medical attention if you experience difficulty breathing.
Dehydration: Difficulty swallowing can lead to dehydration. Ensure adequate fluid intake.
Complications: Untreated quinsy can lead to serious complications such as sepsis, spread of infection to other areas, and recurrent peritonsillar abscesses.
Recurrence: Some individuals may experience recurrent quinsy, which may warrant consideration of tonsillectomy (surgical removal of the tonsils).
Prompt Treatment: Early diagnosis and treatment are crucial to prevent complications and ensure a full recovery.