MFF0032: Quinsy


Medical Fun Facts logo from Gary Lum

Q is for Quinsy and no I’m not talking about Quincy MD, the forensic pathologist played by the late and great Jack Klugman many moons ago.

Given episode 31 was dedicated to pus, this episode in some ways carries on from that.

Quinsy refers to an abscess around the tonsils. Quinsy is fairly uncommon these days, but it is a serious condition.

The abscess usually forms between one of the tonsils and the wall of the pharynx.

It is regarded as a medical emergency because of the serious complications and consequences associated with a growing mass in the throat.

Quinsy can occur in children and adults. Symptoms begin to appear a few days to a week before the abscess forms. The first symptom is often pain when swallowing which is then followed by persistent pain on the side of the abscess along with fever, malaise, headache and hot potato vowels (imagine you have a mouth full of hot potato and you’re trying to count 1 to 10 out loud).

Swollen lymph nodes accumulating cellular immune cells lead to neck pain and swelling with referred ear pain and halitosis. If it’s difficult for the patient to open their mouth, this is a significant sign of an abscess.

A variety of bacteria can cause a quinsy including streptococci, staphylococci, hæmophili, and oral anaerobes.

Quinsy often requires surgical incision and drainage along with antimicrobial therapy.

Complications of quinsy include retropharyngeal abscess, an extension of the abscess into the loose connective tissue spaces of the neck which can lead to a very substantial collection of pus, bacteræmia and septicæmia, and immunological lesions like acute glomerulonephritis and rheumatic fever (when caused by Group A streptococci aka Streptococcus pyogenes).

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