Quinsy

Quinsy is the medical name for a type of abscess which develops on one of both tonsils. It is an uncommon condition although it does affect a small number of people, usually teenagers and young adults and requires medical treatment.

Quinsy can endanger health and even your life if left untreated.

This throat condition is often mistaken for tonsillitis but even though it has similar symptoms it is much worse than this. It causes problems with swallowing and in the worse case scenario can result in a condition called aspiration.

What is quinsy?

Quinsy or to be more precise ‘peritonsillar abscess formation’starts as an inflammation of the tonsils, accompanied by a sore throat as well. It usually affects one tonsil in particular and develops into two pus-filled abscesses on the tonsils. This makes it very difficult to swallow.

It is also very painful as well. In some cases it is almost impossible to swallow.

What is quinsy caused by?

There are two schools of thought on this.

One theory is that quinsy occurs as a complication of tonsillitis. This is said to happen if tonsillitis is left untreated or if it not treated properly.

The second theory is a problem with the Weber’s glands. These glands lie just above the tonsils and produce saliva to clear away any germs or debris from this area.

But this can go wrong which results in a failure of the Weber’s glands to fully clear away any debris from the tonsils. This debris then builds up around the glands and causes a blockage in the ducts. These ducts become swollen and inflamed leading to the formation of an abscess or quinsy.

Symptoms of quinsy

These symptoms are similar to tonsillitis which is why quinsy is often mistaken for this infection. Symptoms of quinsy include:

• A sore throat which worsens over time especially over one side.
• Bad breath
• Painful swallowing
• Drooling of saliva
• Difficulty in opening the mouth
• High temperature
• Earache
• Changes to the tone or pitch of the voice
• Swelling around the neck and face
• Headache
• Feeling unwell or under the weather

The worst aspect of quinsy is the painful sore throat. This causes a great deal of swelling around the infected area which makes it difficult to swallow and in some cases, to breathe normally.

Diagnosing quinsy

If you have tonsillitis or a painful sore throat which is also affecting your breathing then visit your GP. He/she will examine your throat including your tonsils and will confirm or reject a diagnosis of quinsy.

If quinsy has been diagnosed then you will be referred to an ear, nose and throat (ENT) specialist who will carry out tests as part of a further investigation.

It is important to attend to this as soon as possible to stop the infection from spreading, for example into the lungs.

Dangers of quinsy

This is a serious condition which needs to be treated as soon as possible. If left untreated it will worsen over time to the extent that it could become life threatening.

The worst case scenario is that the infected abscess on the tonsil bursts which causes pus to be inhaled. If this reaches the lungs then it can cause a condition called ‘aspiration’. Aspiration occurs when substances or foreign bodies enter the trachea and the lungs.

If this happens then small sections of lung tissue may be damaged or it can result in a serious disease such as chemical pneumonitis. There is also the risk of bacterial infections such as lung abscess or acute respiratory failure.

Treatment for quinsy

This usually involves medication and surgery.

Medication includes a course of antibiotics –usually intravenously - to prevent the infection from spreading. Examples of antibiotics used to treat quinsy include amoxicillin and penicillin.

You may also be given a dose of steroids –also intravenously as this has been shown to help speed up the recovery process. Painkillers are also useful to deal with any discomfort such as a sore throat.

Most cases of quinsy cannot be cured by medication alone which means that surgery is needed.

This means draining away the pus filled fluid from the abscess. Known as ‘needle aspiration’ it involves the use of fine needle which helps to draw out the pus. The surgeon then removes pus from the infected area using this needle.

This pus is then sent to a laboratory for analysis.

Another option is where you are given a local or general anaesthetic before an incision and drainage procedure. The surgeon will make a small incision in the abscess to drain off the infected fluid. This fluid will also undergo laboratory analysis.

Tonsillectomy

If you have a severe form of quinsy or experience this on more than one occasion then a tonsillectomy will be performed. This is surgical removal of the tonsils.

Find out more in our throat surgery section.

This usually deals with the majority of quinsy cases but there are a few situations where quinsy reoccurs even after a tonsillectomy. The reason for this is that it develops between the tonsil and the back of the throat as well as on the actual tonsil itself.

So if you have had quinsy before and it occurred near to your tonsils then there is a risk of it happening again.

Your surgeon or GP will discuss this with you.