Abscess in relation to pharynx
Peritonsillar abscess(Quinsy) It is a collection of pus in the peritonsillar space which lies between the capsule of tonsil and superior constrictor muscle. It originate in the peritonsillar tissue as peritonsillitis and culminates into peritonsillar abscess. The abscess is usually unilateral
Aetiology Acute tonsillitis may arise de novo without previous history of sore throats. It forms an intratonsillar abscess which then bursts through the tonsillar capsule to set up peritonsillitis and then an abscess
Culture of the pus from the abscess may reveal pure growth of strept.pyogenes, staph.aureus or anaerobic organisms
Clinical features General. They are due to septicaemia and resemble any acute infection. They include fever, chills and rigors, general malaise, body aches, headache, nausea and constipation
Clinical features-Local Severe pain in throat. Usually unilateral. Odynophagia. It is so marked that the patient cannot even swallow his own saliva which dribbles from the angle of his mouth. Patient is usually dehydrated
Muffled and thick speech, often called “hot potato voice” Foul breath due to sepsis in the oral cavity and poor hygiene Ipsilateral earache. This is referred pain via CN IX which supplies both the tonsil and ear Trismus due to spasm of pterygoid muscles which are in close proximity to the superior constrictor
Examination 1.the tonsil, pillars and soft palate on the involved side are congested and swollen. Tonsil itself may not appear enlarged as it get buried in the oedematous 2. uvula is swollen and edema and pushed to the opposite side