quinsy n : a painful pus-filled inflammation of the tonsils and surrounding tissues; usually a complication of tonsillitis [syn: peritonsillar abscess]
EtymologyOld French quinencie, from mediaeval Latin quinancia, from Greek κυναγχη ‘canine quinsy’, from κύων ‘dog’ + αγχειν ‘throttle’.
- A painful pus-filled
inflammation or abscess
of the tonsils and
surrounding tissues, usually a complication of tonsillitis, caused by
bacterial infection and often accompanied by fever.
- 1891: He'd had the quinsy and swollen glands when he was young, he told me, and it had left him with a weak throat, and a hesitating, whispering fashion of speech. — Arthur Conan Doyle, ‘A Case Of Identity’ (Norton 2005 p.85)
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).
CausesPTA 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 signsUnlike 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 nodes, 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.
TreatmentTreatment 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. Antibiotics 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
Notable Peritonsillar Abscess (Quinsy) sufferers
- George Washington is believed to have died of complications arising from quinsy.
- 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
- 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.
quinsy in Georgian: პერიტონზილური აბსცესი
quinsy in Dutch: Peritonsillair abces
quinsy in Finnish: Kurkkupaise
quinsy in Portuguese: Abscesso peritonsilar
Asiatic flu, Hong Kong flu, acute bronchitis, adenoiditis, aluminosis, amygdalitis, anthracosilicosis, anthracosis, asbestosis, asthma, atypical pneumonia, bituminosis, black lung, bronchial pneumonia, bronchiectasis, bronchiolitis, bronchitis, bronchopneumonia, catarrh, chalicosis, chronic bronchitis, cold, collapsed lung, common cold, coniosis, coryza, croup, croupous pneumonia, double pneumonia, dry pleurisy, emphysema, empyema, epidemic pleurodynia, fibrinous pneumonia, flu, grippe, hay fever, influenza, la grippe, laryngitis, lipoid pneumonia, lobar pneumonia, lung cancer, lung fever, pharyngitis, pleurisy, pleuritis, pneumococcal pneumonia, pneumoconiosis, pneumonia, pneumonic fever, pneumothorax, rheum, siderosis, silicosis, sore throat, swine flu, the sniffles, the snuffles, tonsilitis, virus pneumonia, wet pleurisy, whooping cough