PERITONSILLAR ABSCESS ( QUINSY )
WHAT IS PERITONSILLAR ABSCESS OR QUINSY ?
Peritonsillar abscess or Quinsy is defined as collection of pus or inflammatory exudate in the tonsillar bed i.e. between the capsule and superior costrictor muscle.It is usually common at the upper pole and in most of the cases it is unilateral. It is more common in adults but children are also not immune. It is the main complication of Tonsillitis.
HOW DOES IT SPREAD ?
1) Pus has to find a way to go out either it causes necrosis in palate and palate then bursts in mouth. It is pressure necrosis. When you drain it out, whole thing subsides.If rupture takes place during sleeping, the patient swallows it, asphyxia and then death occurs.
2) Rupture in the lateral surface from an abscess in neck is called " Parapharyngeal abscess."In lateral wall the great vessels may be involved and give rise to thrombosis, Septicaemia and Pyaemia.
3) The infection can trickle downwards to larynx leading to laryngeal Oedema. This is an unusual fate.
WHAT ARE THE SYMPTOMS ?
1) There is history of sore throat, 2-3 days earlier.
2) There is sudden increase in pain and temperature.
4) Referred pain to ear.
5) Difficulty in opening the mouth.
6) Movements of neck are extremely painful because by moving the neck the movement are transmitted to inflamed tonsillar bed.
WHAT ARE THE SIGNS ?
1) Patient is toxic with high temperature.
2) Opening of mouth is painful.
3) Voice becomes muffled.
4) Dribbling of saliva from the angle of mouth because patient is unable to swallow the saliva.
5) Tongue is coated.
6) Foul smell from the mouth due to bad hygiene.
7) Unilaterally enlarged red, congested tonsil pushed towards the mid line.
8) Adjoining area is also congested.
9) Uvula is oedamatous and pushed towards the opposite side.
10) The movement of palate are restricted.
11) Side of neck is swollen and tender.
WHAT IS THE TREATMENT ?
1) During the stage of Cellulitis :- Conservative treatment. Intensive Antibiotic Therapy.
2) During the stage of Abscess Formation :- Incise and drain the abscess.