Definition It is a collection of pus in the peritonsillar space which lies between the capsule of tonsil and the superior constrictor muscle Or It is a localized accumulation of pus in the ID: 907879
Download Presentation The PPT/PDF document "Quinsy / peritonsillar abscess" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Quinsy / peritonsillar abscess
Slide2Definition
It is a collection of pus in the
peritonsillar
space which lies between the capsule of tonsil and the superior constrictor muscle
Or
It is a localized accumulation of pus in the
peritonsillar
tissues that forms as a result of
suppurative
tonsillitis
Slide3Causes
It occurs as a complication of an untreated or partially treated tonsillitis
Organisms
Streptococcus - GAS
Staphylococcus
Heamophilus
Slide4Pathophysiology
Tonsillitis or
pharyngitis
Tonsilar
crypt get infected and sealed off
Intra
tonsillar abscessIt burst into peritonsillar space through tonsillar capsulePeritonsillitisPeritonsilar abscess
Slide5Peritonsillar abscess (if not treated
)
Laryngeal edema
Parapharyngeal
Abscess
Spread through blood – septicemia – infection to heart (
endocarditis), kidney (nephritis), brain (brain abscess), lungs (lung abscess and pneumonia), airway obstruction, cellulitis of the jaw, neck or chest, pleural effusion
Slide6Signs and symptoms
More common in children
Symptoms start two to eight days before the formation of abscess
Unilateral sore throat and pain during swallowing (
odynophagia
)
Fever, malaise, headache
Distortion of voice – hot potato voiceNeck pain associated with tenderness, swollen lymph nodesReferred ear pain, halitosisDrooling of saliva
Slide7Trismus – limited ability to open the mouth
Redness and edema in the tonsils
Uvula may be displaced towards the unaffected side
Slide8Diagnosis
History collection
Physical examination
Aspiration of the abscess using a needle - culture
CT scan
Ultrasonography
Slide9Management – surgical management
Needle aspiration
– low cost, and good patient tolerance
The mucous membrane over the swelling is first sprayed with a topical anesthetic and then injected with a local anesthetic
Single or repeated needle aspirations are performed to decompress the abscess
Slide10Position – sitting position to make it easier to expectorate the pus and blood that accumulate in the pharynx
Patient experiences almost immediate relief
If 3 ml or more of purulent material is aspirated then patient will likely need to be seen the next day for further aspiration
Slide11Surgical incision and drainage of the pus – this will relieve pain.
Tonsillectomy
– for patients who are not relieved from needle aspiration or incision and drainage.
The risk for bleeding after surgery is more than normal removal of tonsils in tonsillectomy
Slide12Medical management
Antibiotics – to treat infection
Clindamycin
,
metronidazole
in combination with penicillin G