Lightning Learning: Peritonsillar Abscess
Peritonsillar abscess (PTA), aka Quinsy, is a collection of pus in the peritonsillar space.
Despite being the most common complication of tonsillitis, it is still relatively uncommon. PTA incidence peaks at 20-40 years old, and is uncommon in children in under 10 years old.
Patients can present with:
Severe sore throat
Trismus (muscle spasm preventing jaw fully opening)
‘Hot potato’ voice
Uvula deviation away from affected side
It is generally believed that PTA is a result of tonsillitis causing irritation in the peritonsillar space, resulting in a pus collection.
Common causative organisms:
Fusobacterium Necrophorum (15-24 year-olds)
Group A Streptococcus (30-39 year-olds)
Risk factors include recurrent episodes of tonsillitis or partially treated tonsillitis episodes following multiple antibiotics. Smoking is a significant risk factor.
- Teach Me Paediatrics: Peritonsillar Abscess
Definitive management includes aspiration and drainage (this depends on child’s age). Due to mixed causative organisms, antibiotics need to cover anaerobes and aerobes (e.g. Co-amoxiclav).