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| {{Infobox_Disease | | __NOTOC__ |
| | Name = Peritonsillar abscess
| | {{Peritonsillar abscess}} |
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| | DiseasesDB = 11141
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| | ICD10 = {{ICD10|J|36||j|30}}
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| | ICD9 = {{ICD9|475}}
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| | ICDO =
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| | OMIM =
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| | MedlinePlus =
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| | eMedicineSubj = emerg
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| | eMedicineTopic = 417
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| {{SI}}
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| '''Peritonsillar abscess''', also called '''PTA''' or '''Quinsy''', is a recognised complication of [[tonsillitis]] and consists of a collection of [[pus]] beside the [[tonsil]] (peritonsillar space).
| | {{CMG}}; {{AE}} {{PTD}} |
| ==Causes==
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| 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 abscess. PTA can also occur ''de novo''.
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| Both aerobic and anaerobic bacteria can be causative. Commonly involved species include [[streptococci]], [[staphylococci]] and [[haemophilus]].
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| ==Symptoms and signs==
| | {{SK}} PTA, Tonsillar abscess, Intratonsillar abscess, Quinsy |
| Unlike tonsillitis, which is more common in the pediatric age group, PTA has a more even age spread — from children to adults.
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| Symptoms start appearing 2-8 days before the formation of [[abscess]]. Progressively worsening unilateral sore throat and pain during swallowing usually are the earliest symptoms. As the abscess develops,
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| persistent pain in the peritonsillar area, fever, malaise, headache and change in voice (hot potato voice) may appear. Neck pain associated with tender, swollen [[lymph node]]s, referred ear pain and breath odour are also common. Whilst these signs may be present in tonsillitis itself, a PTA should be specifically considered if there is limited ability to open the mouth ([[Trismus]]).
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| Physical signs include redness and edema in the tonsillar area of the affected side and swelling of the jugulodigastric lymph nodes. The [[uvula]] may be displaced towards the unaffected side.
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| <div align="left">
| | ==[[Peritonsillar abscess overview|Overview]]== |
| <gallery heights="175" widths="175">
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| Image:Peritonsillar-abscess-001.jpg|Peritonsillar abscess <small>Image courtesy of RadsWiki and copylefted</small>
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| Image:Peritonsillar-abscess-002.jpg|Peritonsillar abscess <small>Image courtesy of RadsWiki and copylefted</small>
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| Image:Peritonsillar-abscess-003.jpg|Peritonsillar abscess <small>Image courtesy of RadsWiki and copylefted</small>
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| Image:Peritonsillar-abscess-004.jpg|Peritonsillar abscess <small>Image courtesy of RadsWiki and copylefted</small>
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| </gallery>
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| </div>
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| ==Treatment== | | ==[[Peritonsillar abscess historical perspective|Historical Perspective]]== |
| Treatment is, as for all abscesses, through surgical incision and drainage of the pus, thereby relieving the pain of the stretched tissues. The drainage can often be achieved in the Outpatient Department using a guarded No. 11 blade in an awake and co-operative patient. Sometimes, a needle aspiration can suffice. [[Antibiotic]]s are also given to treat the infection.
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| | ==[[Peritonsillar abscess classification]]== |
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| | ==[[Peritonsillar abscess pathophysiology|Pathophysiology]]== |
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| | ==[[Peritonsillar abscess causes|Causes]]== |
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| | ==[[Peritonsillar abscess differential diagnosis|Differentiating Peritonsillar abscess from other Diseases]]== |
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| | ==[[Peritonsillar abscess epidemiology and demographics|Epidemiology and Demographics]]== |
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| Peritonsillar abscesses are widely considered one of the most painful complications, primarily the surgical draining of the abscess itself. The patient is operated on awake, surgically slicing open the tonsil and draining the abscess. | | ==[[Peritonsillar abscess screening|Screening]]== |
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| ==Complications== | | ==[[Peritonsillar abscess risk factors|Risk Factors]]== |
| *Parapharyngeal abscess
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| *Extension of abscess in other deep neck spaces leading to airway compromise
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| *Septicaemia
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| ==Notable Quinsy sufferers==
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| *George Washington is believed to have died of complications arising from Quinsy.<ref name"MountVernon">{{cite web | author =Mount Vernon Plantation | authorlink =Mount Vernon Plantation | year=2006 | url =http://www.mountvernon.org/learn/meet_george/index.cfm/pid/208/ | title =Part 4. President and Back Home | format = | work = Meet George Washington | publisher = Mount Vernon Ladies Association | accessyear =2006 }}</ref>
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| *Michel de Montaigne's quinsy brought about the paralysis of his tongue.
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| *Georges Bizet
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| *James Gregory of the band The Ordinary Boys was almost killed by quinsy because it was left untreated
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| *Brian Sweeney
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| *Alan Burrows
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| ==References== | | ==[[Peritonsillar abscess natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| <references/>
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| ==External links== | | ==Diagnosis== |
| *[http://icarus.med.utoronto.ca/carr/manual/pta.html Practical ENT For Primary Care Physicians web site]
| | [[Peritonsillar abscess history and symptoms|History and Symptoms]] | [[Peritonsillar abscess physical examination|Physical Examination]] | [[Peritonsillar abscess laboratory findings|Laboratory Findings]] | [[Peritonsillar abscess x rays|X Rays]] | [[Peritonsillar abscess other imaging findings|Other Imaging Findings]] | [[Peritonsillar abscess other diagnostic studies|Other Diagnostic Studies]] |
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| *[http://www.drtbalu.com/quinsy.html (Detailed description with video clipping)]
| | ==Treatment== |
| | [[Peritonsillar abscess medical therapy|Medical Therapy]] | [[Peritonsillar abscess primary prevention|Primary Prevention]] | [[Peritonsillar abscess secondary prevention|Secondary Prevention]] |
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| | ==Case Studies== |
| | [[Peritonsillar abscess case study one|Case #1]] |
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| {{Respiratory pathology}} | | {{Respiratory pathology}} |
| {{SIB}}
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| [[Category:Bacterial diseases]]
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| [[ka:პერიტონზილური აბსცესი]]
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| [[nl:Peritonsillair abces]]
| | {{WS}} |
| [[fi:Kurkkupaise]]
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