Quinsy, or peritonsillar abscess, arises when there is a bacterial infection with trapped pus, forming an abscess in the region of the tonsils. Quinsy is a complication of untreated or partially treated tonsillitis, although it can arise without tonsillitis. It is most common in teenagers and young adults, but can occur in children.
Quinsy is most commonly caused by group A streptococcus (Streptococcus pyogenes). Additional bacteria may be involved, including anaerobes.
Presentation
Typical symptoms include:
- Unilateral severe sore throat
- Painful swallowing
- Drooling or difficulty swallowing saliva
- Fever
- Swollen, tender lymph nodes
- Trismus (unable to open their mouth)
On examination, there is:
- Asymmetric peritonsillar swelling
- Uvular deviation away from the affected side
- Muffled or “hot potato” voice
Management
Quinsy requires same-day hospital assessment, analgesia and supportive care (e.g., IV fluids if unable to swallow).
Management of quinsy involves:
- Broad-spectrum antibiotics (e.g., co-amoxiclav)
- Drainage to remove pus from the abscess (by needle aspiration or surgery)
Dexamethasone is sometimes used to reduce pain and swelling, depending on local practice.
Last updated May 2026
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