Peritonsillar abscess

Quinsy, also known as a peritonsillar abscess, is a rare and potentially serious complication of tonsillitis.

The abscess (a collection of pus) forms between one of your tonsils and the wall of your throat. This can happen when a bacterial infection spreads from an infected tonsil to the surrounding area.

Quinsy can occur at any age, but most commonly affects teenagers and young adults. It's possible to get it more than once.

Signs and symptoms

Symptoms of quinsy can include:

a severe and quickly worsening sore throat, usually on one side
swelling inside the mouth and throat
difficulty opening your mouth
pain when swallowing
difficulty swallowing, which may cause you to drool
changes to your voice or difficulty speaking
bad breath
earache on the affected side
headache and feeling generally unwell
difficulty breathing

Some people with quinsy may also have a high temperature (fever), although this sometimes passes before the abscess develops.

When to see your GP

You should see your GP if you or your child have symptoms of quinsy.

Your GP will ask you about your symptoms and examine your throat and tonsils. These are the two small glands found at the back of your throat, behind your tongue.

If quinsy is suspected, you will be referred immediately to a hospital ear, nose and throat (ENT) specialist for further tests and treatment.

It's important that quinsy is diagnosed and treated quickly to prevent the infection from spreading and to avoid serious problems caused by severe swelling, such as breathing difficulties.

Treating quinsy

People with quinsy usually need to be treated in hospital. Depending on how severe the infection is, you may need to stay in hospital for a few days and rest at home for a week or two afterwards.

Medication

You will be given antibiotics to clear the infection. These will usually be given directly into a vein (intravenously) at first, but you may switch to a short course of tablets or capsules once you are well enough leave hospital.

Painkillers, such as paracetamol and ibuprofen, will be given to help ease any pain. You can continue to take these while you recover at home if necessary.

Occasionally, corticosteroid medication may also be used to help reduce the swelling in your throat.

Surgery and procedures

In many cases, antibiotics alone are not effective, and it may be necessary to drain the pus from the abscess. This can be done by:

needle aspiration – a long, fine needle is used to draw out the pus
incision and drainage – a small cut (incision) is made over the affected area to drain the pus
a tonsillectomy – an operation to remove your tonsils (this is rarely necessary while you have quinsy, but is often recommended at least six weeks after you’ve recovered)

You will often remain awake during a needle aspiration or incision and drainage procedure, but you will be given either a sedative to help you relax and/or a local anaesthetic to numb the area being treated.

Tonsillectomies and some incision and drainage procedures are carried out under general anaesthetic. This means you will be asleep and won't feel any pain while these procedures are carried out.

Preventing quinsy

One of the best ways to prevent quinsy is to reduce your risk of developing tonsillitis.

You can help do this by avoiding close contact with people who have viral or bacterial infections that cause tonsillitis, regularly washing your hands with soap and warm water, and not sharing glasses or utensils with people who are ill.

Smoking may increase your risk of quinsy, so stopping smoking may reduce your chances of getting it.

Using antibiotics to treat viral tonsillitis doesn't significantly reduce the risk of quinsy and isn't routinely recommended.