Peritonsillar abscess
| Peritonsillar abscess | |
|---|---|
| Synonyms | quinsy, quinsey |
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| Right sided peritonsillar abscess | |
| Classification and external resources | |
| Specialty | Otorhinolaryngology |
| ICD-10 | J36 |
| ICD-9-CM | 475 |
| DiseasesDB | 11141 |
| MedlinePlus | 000986 |
| eMedicine | emerg/417 |
| MeSH | D000039 |
Peritonsillar abscess (PTA), also known as a quinsy, is a recognized complication of tonsillitis and consists of a collection of pus beside the tonsil in what is referred to as peritonsillar space (peri—meaning surrounding). It is a commonly encountered otorhinolaryngological (ENT) emergency.
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 two to eight days before the formation of an abscess. A progressively severe sore throat on one side and pain during swallowing (odynophagia) usually are the earliest symptoms. As the abscess develops, persistent pain in the peritonsillar area, fever, a general sense of feeling unwell, headache and a distortion of vowels informally known as "hot potato voice" may appear. Neck pain associated with tender, swollen lymph nodes, referred ear pain and foul breath are also common. While 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 of a peritonsillar abscess include redness and swelling in the tonsillar area of the affected side and swelling of the jugulodigastric lymph nodes. The uvula may be displaced towards the unaffected side.
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 an abscess. PTA can also occur . Both aerobic and anaerobic bacteria can be causative. Commonly involved aerobic pathogens include , Staphylococcus and Haemophilus. The most common anaerobic species include Fusobacterium necrophorum, , Prevotella species, and Bacteroides.
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