Quinsy 

Introduction 

Medicines for children

All children have their share of coughs and colds. Find out what medicines you should keep handy

Quinsy, also known as a peritonsillar abscess, is a rare complication of tonsillitis.

The abscess (collection of pus) forms between one of your tonsils and the wall of your throat. This can happen when an infection spreads from an infected tonsil to the surrounding area.

Read more information about the causes of quinsy.

Symptoms of quinsy can include:

  • a worsening sore throat, usually on one side
  • difficulty opening your mouth
  • pain when swallowing
  • difficulty swallowing, which may lead to drooling saliva
  • changes to your voice or difficulty speaking
  • bad breath
  • earache on the affected side
  • headache and feeling generally unwell
  • swelling around your face and neck
  • a high temperature of 38C (100.4F) or above - although the fever may have gone by the time an abscess appears

When to see your GP

You should see your GP if you have:

  • a bad sore throat, or one that gets worse very quickly
  • severe tonsillitis (infection of the tonsils)

Your GP will ask you about your symptoms and examine your throat and tonsils. Your tonsils are the two small glands found at the back of your throat, behind your tongue.

If quinsy is suspected, you will be referred immediately to an ear, nose and throat specialist who will carry out further investigations. You may be admitted to hospital immediately if you have severe quinsy.

It is important that quinsy is diagnosed and treated quickly to prevent the infection from spreading.

If the abscess grows large enough, it can block your airways and cause breathing difficulties. Therefore, it is important treatment is started as soon as possible.

Treating quinsy

Antibiotics will be recommended to clear the infection and painkillers used to deal with any pain. Pus from the abscess may need to be drained. This may involve having a minor surgical procedure carried out under anaesthetic in hospital.

Read more information about how quinsy is treated.

Preventing tonsillitis

The best way to prevent tonsillitis is to avoid close contact with people who have the viral or bacterial infections that cause the condition.

For example, do not share a toothbrush with someone who has tonsillitis and avoid using the same eating and drinking utensils. Maintain a high level of hygiene by washing your hands regularly with soap and hot water.

Smoking could also possibly increase your risk of quinsy. Read about quitting smoking for information and advice about giving up smoking.

How common is quinsy?

Quinsy is not common. This is because most people with tonsillitis have effective treatment early enough to prevent quinsy from developing. For every 100,000 people with a sore throat, 96 may develop quinsy.

Quinsy most commonly occurs in teenagers and young adults. In England during 2011-12, around 7,000 people were admitted to hospital with quinsy.

Page last reviewed: 04/12/2012

Next review due: 04/12/2014

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Comments

The 16 comments posted are personal views. Any information they give has not been checked and may not be accurate.

andy1956 said on 12 August 2014

I am a 58 year old male who works in the construction industry having experienced many tiring and dangerous aspects of this life nothing could have prepared me for the pain I now know to be related to as having a quinsy.
I have just returned home after spending the last 4 days in hospital (with the superb considerate and professional staff at Addenbrookes) where I was so scared because my mouth had swollen in such pain and I couldnt barely breathe.
With a very quick effectual assessment through A&E I was admitted onto a ward where I received the treatment outlined, The relief when the minor incision was made was almost instant even though my wife said I was still talking like a frog and dribbling like a baby!!
It has been a bit of shock but thank goodness all dealt with now-Thank you all at Addenbrookes.

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User231473 said on 27 June 2014

A 'severe' bout of quinsy will leave a person unable to do much, it's quite debilitating. So most people won't experience quinsy the way my son had it, so please don't read this and worry that you'll get it like this, chances are you won't, but I'd like to share his experience anyway.

My son had Quinsy a couple of years ago, he was 9 years old at the time. He was misdiagnosed with simply having tonsilitis, it's quite difficult to diagnose in children. . To cut a long story short, the Ibuprofen hadn't worked and I called an ambulance. He was struggling to breath and was having a panic attack because of it, his temperature had shot up to 42.3C/108F. He was released as soon as his temperature got down to 39C/102F.

His symtoms progressed and he developed septicaemia, his GP then saw him and that's when I was told he had quinsy, it started to affect his kidneys, the GP said he was developing nephritic syndrome which was a complication of his quinsy. The GP was unable to find a hospital bed for him, so she took control of my son's care and after two weeks his health was given the all clear. He felt tired for about 6 weeks afterwards.

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laurat8406 said on 23 June 2014

I have just literally walked out of the hospital today after being admitted with quinsy yesterday morning. After 2 days of not being able to drink or eat, and suffering the most unbearable pain I have ever suffered in my life, and I had a pain relief free labour when having my daughter, I knew it was far worse than tonsillitis. It was the most awful experience having to have the pus drained, and I wouldn't wish it on anybody. Very happy that the doctor was quick to see me and get me diagnosed as soon as he did and got me admitted in. Not bad for a Sunday morning packed out A and E, being seen after only a 30 minute wait when the information board was saying there was an average 2 hour wait.

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James R 94 said on 27 March 2014

About a week and a half ago I started to feel unwell, I thought it was just a cold as I had the normal symptoms, cough, blocked up nose, sore throat. However after a few days all the symptoms had gone except for the sore throat. By the end of the week the sore throat had got even worse and I was finding it painful to swallow. Over the next two days I found it hard to eat or drink, and all of the nodes around my neck had swollen up. I phoned the doctor who prescribed me antibiotics, but the day after that I couldn't even swallow the pills. I went back to the doctors and he said I had possible quinsy, as well as severe tonsillitis. I then got sent straight to the hospital, where I was put on a saline drip and given strong antibiotics and pain killers, with blood tests etc taken. At the hospital they said they had caught the quinsy at an early stage and that it should be okay, but because of sever tonsillitis most of my throat was sore and swallowing was difficult. I can honestly say it was one of the most painful and uncomfortable experiences ever. I couldn't eat or drink without being in pain, and the swelling caused ear ache.

I was in hospital just under 24 hours, and was sent home with penicillin and other medicines. It's now 2 days after I came home and the swelling is only just going down. If I hadn't of gone to my doctors, the quinsy would have been far worse. I encourage anyone who thinks they might have quinsy to get it seen to as soon as possible, doctors, A& E, anything. I didn't think I was that ill, but the hospital wanted me in over night so it must have been pretty bad. Don't leave quinsy to get worse, because it won't go away by itself.

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TBird85 said on 16 March 2014

I had a Quinsy in April last year and it was one of the worst pains I have ever felt. I was running a temp of 104 and my uvula (dangly bit at back of throat) was pushed right over to the other side of my mouth. I was in tears most of the day and struggled to talk, eat, drink the lot. I ended up going to an emergency appointment where I was immediately referred to my local hospital and admitted to the ENT unit. There they numbed the back of my throat and drained the abscess with a long needle, the relief was almost instant!!! I could've kissed the doctor! I was then put on iv antibiotics and fluids due to being dehydrated. I was kept in hospital for 24 hours and by the time I left I was able to eat and drink again with minimal pain. They gave me strong painkillers, paracetamol and Diclofenic, to take at home. I was prone to tonsillitis and due to the Quinsy developing I was referred to get my tonsils removed. I got them removed 13 days ago and My surgeon told me after the op that I had actually had two Quinsy's and that I'd made a good choice by getting them removed as my tonsils were very scarred and pitted from all the bouts of tonsillitis id had. I'm still recovering from the operation but I'm hoping its one of the best things I've ever done!

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7emily42 said on 12 January 2014

I was diagnosed with a quinsy by a doctor at my local surgery after 4 days off of school for misdiagnosed tonsillitis (thanks, nurse. Thanks a lot.). It was absolutely awful. I couldn't speak, it hurt to open my mouth and I found it very difficult to breathe. I kept waking up in the night panting because I was finding it difficult to breathe and could only sleep sitting up as I was producing mucus (sorry for that) at an alarming rate. However, the untreated tonsillitis which lead to this quinsy was misdiagnosed by the local surgery nurse because I apparently didn't have a high temperature and therefore it "wasn't tonsillitis". Prior to this complication, I had had tonsillitis 10 times and had only had a high temperature five times out of 10. I went to the nurse the first time and he said that it was just a mild viral infection, that I would be fine with a day's rest. My condition did not improve at all over the next few days. It actually deteriorated. We went to the nurse again on the Wednesday of that week (having been off of school for the tonsillitis from the Monday) but he actually was rather patronising, implying heavily that I was lying to him and that I was fine. But, just to humour me, he prescribed me some weak penicillin to use "in case I collapse or something". Because of this, my parents began to think that I was lying and sent me to school on the Friday, which I struggled through. Over the weekend, the quinsy symptoms began to develop but my parents didn't realise the severity of these symptoms until I came back from school on the next Monday, hyperventilating and unable to speak. They asked that I see a doctor, not a nurse. and the doctor diagnosed me. I missed a total of 8 days of school because of the nurse. I took some strong antibiotics and was completely fine the next week. Next time I exhibit similar symptoms, my parents will be asking that I specifically see a doctor and not a nurse. Nice one, NHS! (sarcasm)

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Jessiekcoops said on 26 November 2013

I was 28 weeks pregant when I was diagnosed with quinsy for the second time. I think if it wasn't for my pregnancy I wouldn't have been seen so quickly. Although when I first noticed the symptoms as had it before, I was referred to out of hours doctor surgery, where I was sent home with paracetamol. How I was expected to swollow these I dont know and couldn't. The next day my mum called and couldn't understand I word I said over the phone that she came over straight away and called 111 they advised that I went to A&E I hadn't drunk a thing nor eaten in 24hours, and were worried for my baby. Thank god, I was seen straight away and admitted. I was very dehydrated and put on fluid drips as well as iv pain relief and antibiotics. The next day I was allowed home and felt so much better. Luckily I had great care by nhs staff and my baby is well and now 8 weeks old. I had a appointment come straight through to see if I needed my tonsils out, they gave me the option, and said I will most probably get quinsy again I opted to have my tonsils removed, am waiting for the date. There is no way I could cope with a third bout of quinsy, the pain is unbearable. GP's seem to miss diagnose this, if they didn't we wouldn't be going back several times for treatment. We could be dealt with very quickly at hospital and should be the pain is horrendous.

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kizzyL said on 14 October 2013

And now ive got tonsillitis again and I hope it doesn't escalate again to quinsy. I have been In hospital about 5-6 times in the past 5 years to hospital with tonsillitis and quinsy (4 times in the space of six month) each time I was there a week or more. and I hope this doesn't go the same way because im agoraphobic and I can do without that! :( feel like utter rubbish! it really does make u feel low. I only get tonsillitis and quinsy when im very very run down. I don't think ive ever actually caught it off anyone. when I was in hospital last with tonsillitis I saw a surgeon who said they will take them out, I had to beg and beg for it telling them ive ended up losing my job due to being in hospital so many times because of tonsillitis. but that operation never came! the referral letter never arrived. the NHS is terrible!

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egu1169 said on 06 September 2013

I am currently in hospital treted with quinsey and I had similar experiences to those read in previous comments: only hospital staff diagnosed it correctly and therefore treated it properly, with intravenous medicines and by draining the abscess. They couldn't believe the GPs didn't recognised the symptoms and sent me home with painkillers. On the one hand, hospital NHS staff and facilities are simply wonderful: paramedics, nurses and doctors in wards and A&E, compassionate and thorough, explaining everything in detail. On the other hand, unfortunately GPs have one agenda only: send you home with painkillers, and with a dismissive "it's probably nothing" attitude, emotionally detached, considering you a baby because you complain about pain,treating you as you were wasting their time. It's like having two different NHSs. This is not justifiable or even understandable, consider the level of stress all hospital staff go through night and day, compared to the quiet GP surgery premises, which look nothing like surgeries but more like admin offices. To my experience, a GP will hardly leave their computer keyboard to attempt a first examination, unless you insist and keep moaning, which I find rather belittling.

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JMT2809 said on 19 July 2013

Sore throat and fever began on Monday. I saw that my right tonsil was inflamed and covered in white spots. I've had tonsillitis before so I managed it with Ibuprofen and Paracetamol and waited for it to get better.

On Wednesday evening it suddenly got much more painful. I couldn't open my mouth very far or swallow. I had a look in my mouth and realised that I had a massive swelling in front of my tonsil, about the size of a Brussels Sprout. I called NHS Direct and got through to a nurse who recommended I gargle soluble co codamol. This didn't help. I was still in agony and couldn't sleep so called the out of hours service and begged to see a doctor.

I saw a doctor at 2am on Thursday morning. He looked at my throat and said it definitely wasn't tonsillitis and definitely didn't need antibiotics. He said it was a virus and referred to it as 'just a sore throat'. I begged him for pain relief as I had never experienced anything this bad. My ear, gums, tongue, neck and everything around the lump was so painful. I asked him if he was really sure it wasn't tonsillitis because I'd seen white spots on my tonsil. He said it definitely wasn't but gave me a strong painkiller injection and a prescription for co codamol.

I was in a lot of pain the next day. I was concerned that it was getting worse, not better and that the swelling in my throat was so big. I couldn't eat anything. I called my GP to say that I wanted a second opinion about whether antibiotics would help but he said I'd already seen a doctor who didn't think it was bacterial.

On Thursday evening the 'swelling' popped and I realised that it was an abscess. I looked it up and found that it was a complication of tonsillitis and did need antibiotics. I called the out of hours service (again) and was finally seen and given antibiotics.

It's now Friday and I'm still in pain and waiting for the antibiotics to kick in. The abscess keeps refilling with pus so is still painful.

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YoungStudent said on 05 June 2013

I was one of the younger patients to be diagnosed with quinsy earlier this year. The pain was terrible, the inability to swallow food let alone your own saliva! I eventually got treated with a local anesthetic to remove the pus from the tonsils. Painful experience, i hope no one else will get this.

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FeeB said on 16 April 2013

My experience of quinsy.
Mon 3:30pm: pain on swallowing, sore throat begins.
Tues am: sore throat, shivers/shakes, temp, feel rough. Take paracetamol and ibruprofen.
Tuesday 3:30pm: get home, go to bed with shivers/shakes, temp, more paracetamol. Urine red/brown colour.
Tues pm: temp 39.7 even with paracetamol. Go to MIIU Told 'It's probably a viral throat infection...most throat infections are...stay in bed, fluids etc etc'
Weds 4am: vomit green mucousy substance, temp. Ring 111 number - told probably viral etc ring GP surgery in morning,
Wed 8am: ring GP surgery. Reluctant to give appointment because of vomiting. Probably viral, stay at home.
Wed evening: Can hardly swallow, open mouth, drooling, can't talk properly, tongue coated white, neck swollen on one side, urine very dark, burns to pee and stinks to high heaven.
Thurs: Insist on appointment with GP - diagnoses tonsilitis. Notes I had a pharyngeal infection treated with antibiotics four weeks previously. Prescribes penicillin and advises paracetamol and ibruprofen. Tests urine - tells me I'm dehydrated and to drink more fluids. I burst into tears because I can't swallow water let alone paracetamol or penicillin. Tells me to crush them.
Fri - Sat: stay in bed (have been there pretty much constantly since Tues), take penicillin etc. Very little relief to the sore throat. Urine still dark and stinky. Still in a lot of pain, drooling, coughing on thick mucous etc.
Sat: 48 hours after starting penicillin, ring 111 for advice. Told to see own GP within 3 days. Look for info on tonsilitis, find this page.
Sun: A&E visit - quinsy diagnosed. Admitted to hospital. IV fluids, antibiotics and steroids. Abscess aspirated. Just home.
Gruesome.

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Louise Clarke said on 30 March 2013

I was admitted to hospital last night with a Quinsy. I can't tell you how painful this condition is, I am in agony.
Went to the doctors at the beginning of the week and she said it was a nasty virus but I knew what tonsilitis felt like after having it a few times and this was it.
I soldiered on all week on paracetamol and ibuprofen that weren't touching the pain until yesterday when I couldn't take any more and ended up at the walk in centre and the nurse there said the same thing and I sobbed.
Was getting into bed last night and could feel and see this huge lump in my throat and looked and found the Quincy.
Headed straight to A & E and got admitted at 2am with Quincy and now on IV Antibiotics and steroids and strong painkillers. If I'd have been given them at the beginning if the week, maybe I wouldn't be in this situation??
Symptoms are: constant nagging horrendous throat pain, impossible to swallow, drooling, temp, painful neck and ear and generally feeling awful.
Waiting to see if they want to drain any pus from the Quincy because they couldn't get any out this morning.

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Isi23 said on 24 March 2013

I had treatment for a quinsy in September 2012. Symptoms included an extremely sore throat on one side and swelling a day later. Initially it was misdiagnosed as a wisdom tooth being the cause of the swelling.

I investigated further and a huge thanks to the radiologist who took an x-ray of my jaw to confirm I was misdiagnosed. I was sent straight to the ENT department (ear, nose and throat) and within 2 days after intravenous antibiotics I was discharged.

It was very quick to sort once I was diagnosed correctly and I was looked after well. :)

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Mumsy100 said on 27 February 2013

Glad I read this - my throat is currently receiving Peniccilin but the pain!!!! Why don't painkillers work?

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DBTrain said on 16 January 2013

I have just returned from hospital after treatment for a quinsy. The diagnosis took a while as the pain was in my ear[!] and I was convinced that it was my ear that was infected. The hospital [Calderdale] looked after me brilliantly - the quinsy was lanced and extruded[?] and I was kept in overnight on penicillin / rehydration drips. The treatment was so much less painful that the symptoms which were horrific! Just posted this to let people know that it wasn't a sore throat in my case - but severe ear ache! x x x

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