Quinsy in Adult: Clinical Profile and Management Challenges in Two Tertiary Hospitals Northwest Nigeria

Abstract

Purpose of the Study: Quinsy also known as Peritonsillar abscess (PTA) is a life threatened complication of acute exudative tonsillitis requiring immediate surgical intervention. We profile the clinical presentation and highlight challenges in management. Materials and Methods: A retrospective analysis of all patients diagnosed with Quinsy at the departments of otorhinolaryngology of two-government referral hospital in northwest Nigeria from May 2014 to April 2017. These patients’ clinical records were retrieved from the health record department and data extracted were analyzed using Microsoft excel program. Results: A total of 147 adult patients had tonsillitis within the study period. Only eighteen patients with quinsy 13(72.2%) females and 5(27.8%) males with an M: F=1:2.6 were analyzed. Age range is between 18 years – 58 years with a mean age of 35.4 years. The highest incidence was 66.7% in patients within the age group 21-40 years. Odynophagia and trismus were the commonest presenting features in all the patients. Side of Quinsy involvement was on the left tonsils 12(66.7%). There was spontaneous rupture in 5(27.8%) while 13(72.2%) of patients had incision and drainage. All patients had broad-spectrum antibiotics. Interval tonsillectomy was carried out on 12(66.7%) of patients while 6(33.3%) of patients did not consent for tonsillectomy and were subsequently lost to follow up. No recurrence of symptoms or mortality recorded. Conclusion: Quinsy is a life threatening otorhinolaryngological emergency common amongst young female adults. Optimal management is still antibiotics therapy and drainage of abscess in our center.