Peritonsillar Abscess

A peritonsillar abscess (PTA), also called quinsy, is a bacterial deep-neck infection in which pus collects between the tonsillar capsule and the adjacent pharyngeal muscles. It may develop after pharyngitis or tonsillitis. The infection can include group A Streptococcus, Staphylococcus aureus, Haemophilus influenzae, and β-lactamase-producing organisms, so treatment must cover more than a single uncomplicated throat pathogen. The collection distorts nearby structures. Swelling of one soft palate pushes the uvula toward the opposite side, while inflammation near the muscles of mastication produces trismus, or inability to open the mouth fully. Pain and narrowing around the oropharynx make swallowing difficult; drooling means the patient may no longer be able to manage oral secretions. The altered resonance of the voice produces the characteristic muffled “hot-potato” quality. A patient with simple pharyngitis may have a sore throat and fever, but pronounced unilateral palatal swelling, contralateral uvular deviation, trismus, and a muffled voice point toward a deeper collection. Peritonsillar cellulitis can look similar but does not contain a drainable pocket of pus. If the infection extends beyond the peritonsillar space, aspiration, sepsis, and deeper...