Peritonsillar abscess

Peritonsillar abscess ( also known as quinsy ) is a localised deep neck infection that develops between the tonsil and its capsule.

Three main sets of tonsils

Pharyngeal tonsils Commonly called as adenoids -found midline in the nasopharynx.

Lingual tonsils Found in posterior one third of the tongue.

Palatine tonsils - Lie in the tonsillar fossa- encapsulated by a specialised portion of pharyngobasilar fossa. Most commonly infected set of tonsils.

Purulent complication of acute tonsillitis ( most commonly cited hypothesis )

Obstruction of supratonsillar Weber's glands ( Weber gland hypothesis )

Infections can be polymicrobial or monomicrobial ( microbiology of PTA is not very clear )

Majority are considered to be polymicrobial infections containing common oropharyngeal flora

Role of key pathogens has been established as Streptococcus pyogens

Fusobacterium necrophorum

Streptococcus milleri group

Infection spreads beyond the capsule causing peritonsillitis and then subsequently pertonsillar abscess ( PTA )

PTA may happen after tonsillectomy without tonsillar remnants

How common Adolescents and young adults most commonly affected ( although it can happen in any group )

Most common deep infection of the head & neck in young adults

Role of seasonality is not clear

No racial or sexual predilection

Reported incidence of 10...