Peritonsillar abscess
1145110
224771309
2008-07-10T10:13:33Z
93.96.13.10
/* Notable Peritonsillar Abscess (Quinsy) sufferers */
{{Infobox_Disease
| Name = Peritonsillar abscess
| Image = Throat_with_Tonsils_0012J.jpeg
| Caption = Visible abscess beneath right tonsil
| DiseasesDB = 11141
| ICD10 = {{ICD10|J|36||j|30}}
| ICD9 = {{ICD9|475}}
| ICDO =
| OMIM =
| MedlinePlus =
| eMedicineSubj = emerg
| eMedicineTopic = 417
| MeshID = D000039
}}
'''Peritonsillar abscess''', also called '''PTA''' or '''Quinsy''', is a recognised complication of [[tonsillitis]] and consists of a collection of [[pus]] beside the [[tonsil]] (peritonsillar space).
==Causes==
PTA usually arises as a complication of an untreated or partially treated episode of acute tonsillitis. The infection, in these cases, spreads to the peritonsillar area (peritonsillitis). This region comprises loose connective tissue and is hence susceptible to formation of abscess. PTA can also occur ''[[de novo]]''.
Both aerobic and anaerobic bacteria can be causative. Commonly involved species include [[streptococci]], [[staphylococci]] and [[hemophilus]].
==Symptoms and signs==
Unlike tonsillitis, which is more common in the pediatric age group, PTA has a more even age spread — from children to adults.
Symptoms start appearing 2-8 days before the formation of [[abscess]]. Progressively worsening unilateral sore throat and pain during swallowing usually are the earliest symptoms. As the abscess develops,
persistent pain in the peritonsillar area, fever, malaise, headache and change in voice (commonly called "hot potato voice", as it may sound that the patient is attempting to talk with a mouth half-full of mashed potatoes) may appear. Neck pain associated with tender, swollen [[lymph node]]s, referred ear pain and breath odour are also common. Whilst these signs may be present in tonsillitis itself, a PTA should be specifically considered if there is limited ability to open the mouth ([[trismus]]).
Physical signs include redness and edema in the tonsillar area of the affected side and swelling of the jugulodigastric lymph nodes. The [[uvula]] may be displaced towards the unaffected side.
==Treatment==
Treatment is, as for all abscesses, through surgical incision and drainage of the pus, thereby relieving the pain of the stretched tissues. The drainage can often be achieved in the Outpatient Department using a guarded No. 11 blade in an awake and co-operative patient. Sometimes, a needle aspiration can suffice. [[Antibiotic]]s are also given to treat the infection.
Peritonsillar abscesses are widely considered one of the most painful complications, primarily the surgical draining of the abscess itself. The patient is often operated on awake, surgically slicing open the abscess and clearing the drainage with suction.
Treatment can also be given while a patient is under anesthesia, but this is usually reserved for children or increasingly agitated or anxious patients.
==Complications Associated With Peritonsillar Abscess==
*Parapharyngeal abscess
*Extension of abscess in other deep neck spaces leading to airway compromise
*[[Septicaemia]]
*Possible [[Necrosis]] of surrounding deep tissues
*In rare cases, [[Mediastinitis]]
==Notable Peritonsillar Abscess (Quinsy) sufferers==
*[[George Washington]] is believed to have died of complications arising from quinsy.<ref name"MountVernon">{{cite web | author =Mount Vernon Plantation | authorlink =Mount Vernon Plantation | year=2006 | url =http://www.mountvernon.org/learn/meet_george/index.cfm/pid/208/ | title =Part 4. President and Back Home | format = | work = Meet George Washington | publisher = Mount Vernon Ladies Association | accessyear =2006 }}</ref>
*[[Michel de Montaigne]]'s quinsy brought about the paralysis of his tongue.
*[[Georges Bizet]]
*James Gregory of the band [[The Ordinary Boys]] was almost killed by quinsy because it was left untreated
*Brian Sweeney
*George Nock
*Alan Burrows
*[[Laurence Llewelyn-Bowen]] described suffering from quinsy as a young man on the BBC programme ''A Grumpy Guide to Teenagers''
*Australian graphic designer Jason Hamilton was diagnosed with quinsy in early 2008 and is currently being treated for the disease.
==References==
<references/>
==External links==
*[http://icarus.med.utoronto.ca/carr/manual/pta.html Practical ENT For Primary Care Physicians web site]
*[http://www.drtbalu.com/quinsy.html (Detailed description with video clipping)]
{{Respiratory pathology}}
[[Category:Bacterial diseases]]
[[ka:პერიტონზილური აბსცესი]]
[[nl:Peritonsillair abces]]
[[fi:Kurkkupaise]]
[[pt:Abscesso peritonsilar]]