In which of the following locations, there is collection of pus in the quinsy
PERITONSILLAR ABSCESS (QUINSY) It is a collection of pus in the peritonsillar space which lies between the capsule of tonsil and the superior constrictor muscle. AETIOLOGY :- Peritonsillar abscess usually follows acute tonsillitis though it may arise de novo without previous history of sore throats. First, one of the tonsillar crypts, usually the crypta magna, gets infected and sealed off. It forms an intratonsillar abscess which then bursts through the tonsillar capsule to set up peritonsillitis and then an abscess. Culture of pus from the abscess may reveal pure growth of Streptococcus pyogenes, S. aureus or anaerobic organisms. More often the growth is mixed, with both aerobic and anaerobic organisms. CLINICAL FEATURES :- Peritonsillar abscess mostly affects adults and rarely the children though acute tonsillitis is more common in children. Usually, it is unilateral though occasionally bilateral abscesses are recorded. Clinical features are divided into: 1. General:- Theyare due to septicaemia and resemble any acute infection. They include fever (up to 104degF), chills and rigors, general malaise, body aches, headache, nausea and constipation. 2. Local :- (a) Severe pain in throat. Usually unilateral. (b) 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. (c) Muffled and thick speech, often called "hot potato voice." (d) Foul breath due to sepsis in the oral cavity and poor hygiene. (e) Ipsilateral earache. This is referred pain CN IX which supplies both the tonsil and the ear. (f) Trismus due to spasm of pterygoid muscles which are in close proximity to the superior constrictor. Ref:- Dhingra; pg num:-264,265
Parapharyngeal space
Retropharyngeal space
Peritonsillar space
Within the tonsil
Pharynx