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Peritonsillar abscess (quinsy)

A peritonsillar abscess is a pus-filled sore that develops in the region of the tonsils.

A woman holding her throat in pain

Peritonsillar abscess (also called quinsy) describes an accumulation of pus and infected material that may form alongside one of the tonsils in the back of the throat. 

Tonsillitis is a common infection of the tonsils and it is most often untreated tonsillitis spreading to the surrounding tissue that causes peritonsillar abscess. Streptococcal bacteria, the same organisms that cause strep throat, are commonly responsible for this type of infection. 

Peritonsillar abscess can also be caused by glandular fever (mononucleosis or mono), a condition caused by the Epstein-Barr virus, and by dental infections. If a peritonsillar abscess is not swiftly treated it can rupture and lead to dangerous complications such as pericarditis (inflammation of the lining around the heart), obstruction of the airway, pleural effusion (build-up of excess fluid around the lungs) and pneumonia.

What are its symptoms?

Peritonsillar abscess symptoms may set in several days before the abscess forms, becoming more pronounced as the sore develops. Symptoms include:

  • Increasingly severe sore throat with pain usually localised on one side
  • Difficulty swallowing
  • Difficulty and pain accompanying opening of the mouth
  • Fever
  • Enlarged lymph nodes and tenderness in the neck
  • Muffling of the voice
  • Headache and sometimes ear pain on the same side as the abscess
  • Bad breath
  • Signs of inflammation and redness in the tonsil area at the back of the throat

How is it diagnosed? 

Diagnosis of a peritonsillar abscess is often possible from a physical examination alone. Your doctor will be able to ascertain if there are signs of swelling on one side of the throat and oftentimes the abscess itself may be visible. 

A swab may be used to collect a culture from your throat for further testing to identify the causative organism but this is rarely necessary as treatment is likely to remain the same regardless of the bacterium involved.

What are your treatment options? 

Peritonsillar abscess treatment commonly involves a course of antibiotics to address the infection at the root of the abscess. 

However, sometimes this is not enough and the abscess may need to be drained of its infected contents. This can be done by needle aspiration, a procedure that can be performed by an ear, nose and throat specialist that involves using a needle and syringe to withdraw the pus, or via a surgical incision. 

Your specialist may advise removing your tonsils at the same time, a day procedure which is done while the patient is under general anaesthetic.

Can it be prevented? 

The most important key to the prevention of peritonsillar abscess is ensuring that tonsillitis is treated swiftly, before complications have time to set in. The same is applicable in cases of glandular fever (mononucleosis). If your doctor prescribes antibiotics for the treatment of tonsillitis it is essential to finish the entire course of treatment, otherwise the disease may recur, once again putting you at risk of further complications. 

Practicing good oral hygiene and quitting smoking (a risk factor for many infections of the mouth and throat) can also reduce your chances of developing a peritonsillar abscess.

IMAGE CREDIT: 123rf.com

The accuracy of this information was checked and approved by physician Dr Thomas Blake in July 2016