What is Quinsy?

• Quinsy occurs when an abscess forms at the top of one of the tonsils
• An abscess is a collection (or bag) of pus
• The tonsils are the 2 lumps you can see in your throat when you open your mouth wide
  • They sit in the bottom corners at the back (behind your tongue)
  • They are either side of the dangly “uvula” which hangs from the top

What are the symptoms of Quinsy?

• Worsening sore throat
• Feeling unwell
• Significant difficulty swallowing
• Smelly breath
• Usually a fever (high temperature)
• Usually the glands are up in your neck
• Sometimes earache
• Sometimes difficulty opening the mouth wide
• Sometimes it causes you to speak with a strange voice, sounding like you have a golf ball in your mouth

What does Quinsy look like?

• The tonsil that has the abscess will look large, often pushing the uvula (which normally dangles in the middle) off to one side
• The uvula itself may look swollen
• Your mouth may look “yucky” or unclean

Who gets Quinsy?

• Quinsy starts during tonsillitis
• It’s commoner in people who get tonsillitis recurrently
• It happens to between 1 and 4 in 10,000 people per year
• Tonsillitis is when your tonsils become swollen, inflamed and painful
  • This is usually caused by bacteria or viruses
• People with tonsillitis can therefore progress to developing quinsy
• Anybody can develop quinsy. Certain people are more likely to get it:
  • People on immune-suppressing medications
  • People with illnesses affecting the  immune system (eg. HIV)
  • People with diabetes
  • Smokers
  • People with poor dental health (bad teeth/gums) – (1, 2)

What causes Quinsy?

• Bacteria responsible for tonsillitis (usually Streptococcus or Haemophilus species) form an abscess on a tonsil
• It’s not known why this happens

What is the treatment for Quinsy?

• You need to go to hospital urgently, as it’s important that quinsy is treated before it affects your breathing
• Antibiotics given intravenously (in a drip, usually into your arm)
• You’ll usually be given intravenous fluids as well (for dehydration)
• Sometimes steroids are given – these have been shown to help
• The abscess will usually be drained by a doctor, using a scalpel (sharp surgical knife) or a needle
  • Usually the area is numbed first using a spray
  • Some people have a general anaesthetic for this (surgery after being put to sleep)

Can I die of Quinsy?

• Yes, though this extremely rare if you are treated in hospital
• Outcomes are usually excellent if the right treatments are given

What’s the prognosis for Quinsy?

• Outcomes are generally very good
• You usually need to have your tonsils surgically removed (tonsillectomy) a few weeks after you’ve recovered to prevent it from happening again

Article Resources

1 Geißler K et al Functional characterization of T-cells from palatine tonsils in patients with chronic tonsillitis

2 Wikstén J at al Renewal of peritonsillar abscess: Impact of the bacterial species of the infection and clinical features of the patient-A prospective comparative aetiological study