Quinsy

Background: Patients will present with unilateral throat pain, trismus and often have a muffled quality to their voice (“hot potato” voice). On examination, trismus may be evident and it may make visualising the back of the throat difficult. If the back of the throat is visible, there is often a bulge in the tissue of the soft palate just above the tonsil. This can cause uvular deviation to the opposite side. However, it is important to note that deviation of the uvula describes the base of the uvula off the midline, rather than its tip which can occasionally stick to the wall of the throat temporarily. In addition, the presence of unilateral throat pain and trismus are more predictive for the diagnosis of quinsy compared to uvular deviation. Therefore, if there is no unilateral throat pain and no trismus, the diagnosis of quinsy is very unlikely.

James Heilman,MD, CC BY-SA 3.0 https://creativecommons.org/licenses/by-sa/3.0, via Wikimedia Commons https://commons.wikimedia.org/wiki/File:PeritonsilarAbsess.jpg  

Referral Guidance:

Refer patients with suspected quinsy to ENT as an emergency for consideration of same-day review