Examination 3. bulging of the soft palate and anteriorpillarabove the tonsil4.mucopusmaybeseencoveringthetonsilarregion5.cervicallymphadenopathyiscommonlyseen.6.torticollis.Patient keeps the necktiltedtothesideofabscess
Examination 3. bulging of the soft palate and anterior pillar above the tonsil 4.mucopus may be seen covering the tonsilar region 5. cervical lymphadenopathy is commonly seen. 6. torticollis. Patient keeps the neck tilted to the side of abscess
Differential diagnosis1. acute tonsillitis is usually bilateral, the painis not very severe and usually does notradiatetotheear2.retropharyngeal abscess andparapharyngeal abscess may bequite similar.3.malignant tumor of the tonsil:lymphoepithelioma maymimicquinsy,but itismore chronic andless painful. It is hard tofeel, and pus does not drain on incising it
Differential diagnosis 1. acute tonsillitis is usually bilateral, the pain is not very severe and usually does not radiate to the ear 2. retropharyngeal abscess and parapharyngeal abscess may be quite similar. 3. malignant tumor of the tonsil: lymphoepithelioma may mimic quinsy, but it is more chronic and less painful. It is hard to feel, and pus does not drain on incising it
ComplicationsParapharyngealabscessmaydevelopLocalvenousthrombosisorphlebitisofthe internal jugular vein may occunSepticaemiamay resultfromthrombophlebitisHemorrhage may occur dueto necrosisof the internal carotid arterySupraglotticedemawithobstructiontoairway
Complications Parapharyngeal abscess may develop Local venous thrombosis or phlebitis of the internal jugular vein may occur Septicaemia may result from thrombophlebitis. Hemorrhage may occur due to necrosis of the internal carotid artery Supraglottic edema with obstruction to airway
Treatment1.hospitalisation2. intravenous fluids to combatdehydration3.antibiotics.Suitable antibiotics inlargei.v.dosestocoverbothaerobicandanaerobicorganism
Treatment 1. hospitalisation 2. intravenous fluids to combat dehydration 3. antibiotics. Suitable antibiotics in large i.v. doses to cover both aerobic and anaerobic organism