Quinsy

 Q: 26 years old male is admitted to ICU for airway vigilance and signs of sepsis due to peritonsillar abscess. On physical exam, the uvula is expected to deviate towards? (select one) 

A) the affected side 

B) the unaffected side

Answer: B

Peritonsillar abscess is popularly known as quinsy. This is a suppurative extension of acute tonsillitis into the peritonsillar space. It is common in young adults. It is usually an abscess formation near the superior pole of the tonsil. Signs and symptoms consist of fever, odynophagia, sore throat which tends to be unilateral, otalgia, muffled voice (hot potato voice), trismus, unilateral deviation of the uvula towards the unaffected side, and soft palate edema.  

It requires quick recognization and treatment with drainage and/or antibiotics to avoid airway compromise. In severe edema, steroids can be considered.

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References:

1. Galioto NJ. Peritonsillar Abscess. Am Fam Physician. 2017 Apr 15;95(8):501-506. PMID: 28409615.

2. Steyer TE. Peritonsillar abscess: diagnosis and treatment. Am Fam Physician. 2002 Jan 1;65(1):93-6. Erratum in: Am Fam Physician 2002 Jul 1;66(1):30. PMID: 11804446.