Infectious Disease Compendium

Quinsy

Diagnosis

Peritonsillar abscess with severe pain and dysphagia; marked asymmetry on exam. CT makes the diagnosis.

Epidemiologic Risks

Streptococcal pharyngitis.

Microbiology

Group A streptococci.

Empiric Therapy

Drain it, then penicillin or any other beta lactam will nuke a group A strep. Initially over treat until cultures back as could be a mixed infection: third generation cephalosporins PLUS metronidazole OR clindamycin OR penicillin/beta-lactamase inhibitors OR quinolone PLUS metronidazole OR quinolone PLUS clindamycin OR carbapenems.

Pearls

It killed Jack Klugman. Get it? He played Quincy on TV and he died of Quinsy? Now do you get it? Sigh. At least he didn't play a character called Gleet.

Rants

ICD9 Codes (Soon to be supplanted by ICD10)

quinsy 475.