Quinsy (peritonsillar abscess): symptoms and when to get help

What is quinsy?

Quinsy is the old and still widely used name for a peritonsillar abscess: a pocket of pus that forms in the space between a tonsil and the muscle wall of the throat behind it. It is almost always one-sided, because the abscess forms beside one tonsil rather than both.

It usually develops as a complication of tonsillitis or pharyngitis, often at the point where a sore throat seemed to be settling and then turned sharply worse. Occasionally it starts from infection of a small salivary gland sitting above the tonsil rather than from tonsillitis at all. Quinsy is most common in teenagers and young adults, though it can happen at any age. Healthdirect Australia describes it as an uncommon complication of tonsillitis, but it is the most common deep infection of the head and neck, and it is a same-day problem.

The important thing to hold onto is the difference in what each condition needs. Most sore throats and most tonsillitis can be managed at home, or with a GP consultation by video. Quinsy cannot. Pus in a closed space has to be drained, and that is done with hands, in person.

Quinsy symptoms: how it differs from bad tonsillitis

Plenty of tonsillitis feels dreadful without being quinsy. The pattern below is what tips the balance. If several of these are present together, and particularly if things are getting worse rather than better, go and be seen in person today:

• Severe pain on one side. The throat pain is not evenly spread; one side is markedly worse.
• Difficulty opening the mouth (trismus). The jaw muscles beside the abscess go into spasm, so the mouth will not open properly. This is one of the most telling signs.
• A muffled hot potato voice. The voice sounds thick and hot, as though there is something in the mouth.
• Drooling, or trouble swallowing saliva. Swallowing is so painful that saliva pools rather than being swallowed.
• Ear pain on the same side. Referred pain to the ear on the affected side is common, and can be mistaken for an ear infection.
• The uvula pushed to one side. The soft tissue above one tonsil bulges, and the uvula, the small tag hanging at the back of the throat, is pushed away from the swollen side.
• High fever and feeling very unwell. Most people with quinsy look and feel significantly sicker than with ordinary feverish tonsillitis, often with swollen, tender glands in the neck.

Tonsillitis vs quinsy at a glance

This table is a guide for deciding how urgently to be seen, not a way to diagnose yourself. The diagnosis is made by someone looking into your throat in person. If the picture on the right-hand column is closer to yours, that is the signal to go, not the signal to keep reading.

Is quinsy contagious?

The abscess itself is not contagious. You cannot pass a peritonsillar abscess to someone else: it is a pocket of pus that has formed in your own tissue, not something transmitted between people.

The infections that lead to it are a different matter. Healthdirect Australia notes that tonsillitis is not contagious, but the viruses and bacteria that cause tonsillitis can be spread to other people. So a housemate or family member will not catch quinsy from you, but they can catch the throat infection that started it. Handwashing, covering coughs and sneezes, and not sharing cups, bottles, or cutlery are the measures that matter while anyone in the house has a sore throat.

What to do now: quinsy needs same-day, in-person care

Call 000 immediately if there is any of the following, which can mean the airway is threatened:

• Difficulty breathing, noisy breathing, or working hard to breathe
• Inability to swallow fluids at all
• Drooling with distress, or a change in the sound of the voice with breathlessness
• Severe swelling of the neck, or an inability to lie flat comfortably

Otherwise, go to an emergency department the same day. You can check live waits at nearby EDs before you leave, but do not let a long posted wait talk you out of going: throat abscesses are triaged on how sick you look and how your airway is, not on arrival order. If it is easier, your usual GP practice can also see you in person and send you on.

Do not wait to see whether it settles overnight, and do not start on leftover antibiotics from a previous illness. Oral antibiotics alone do not reliably clear an established abscess, and taking a partial course beforehand can muddy the assessment when you are finally seen.

How quinsy is treated in hospital

Treatment has two halves: get the pus out, and treat the infection.

• Drainage. The abscess is drained in person, usually by needle aspiration or a small incision, sometimes under local anaesthetic and sometimes in theatre. This is the part that produces rapid relief.
• Antibiotics. Chosen to cover the bacteria typically involved, and often started intravenously before switching to an oral course to finish at home.
• Supportive care. Pain relief and fluids matter more than people expect, because swallowing has usually been too painful to keep up with drinking. A single dose of a corticosteroid is sometimes given to reduce swelling.
• ENT involvement. Suspected peritonsillar abscesses are referred to the ear, nose and throat team, and many people are admitted for a short stay.

Most people feel substantially better within a day or two of drainage, with swallowing, jaw stiffness, and tiredness taking a little longer to settle. Recovery varies between people, so treat any timeline as a general guide.

Where a telehealth GP genuinely fits

NewDoc is a pure telehealth service, so it is worth being direct about this: a video consult cannot treat established quinsy. There are three points, though, where a GP consultation by video is the right tool.

1. Before: working out what your sore throat actually is. Most sore throats are not quinsy. If yours is painful and you are unsure how worried to be, an AHPRA-registered GP can take the history, look at your throat on video, and separate ordinary tonsillitis and sore throat, which a GP can treat, from the red-flag pattern that needs an emergency department now. Getting told clearly and quickly to go in is a useful outcome of a consultation, not a wasted one.

2. After: the follow-up tail. Once the hospital part is done, most of what remains is general practice work. A GP can review how you are recovering, help you complete the oral antibiotic course, issue a medical certificate for the time you have needed off work or study, and arrange an ENT referral to discuss recurrent tonsillitis or recurrent quinsy.

3. The rest of the household. Sore throats travel through families. Other people at home with a sore throat can be assessed by video, treated where treatment is warranted, and given the same clear list of features that would mean going in.

For eligible Medicare cardholders, the consultation and any certificate, script, or referral issued during it are bulk billed with no out-of-pocket cost, with a median 5.0 hours booking-to-consult per NewDoc April 2026 utilisation data. None of that changes the rule above: if the quinsy pattern is there, the emergency department is the right destination.

Recurrence, and when tonsils come into the conversation

Most people who have quinsy once never have it again. A minority do, and the risk is higher in people with a history of repeated tonsillitis. There is no way to guarantee it will not recur, but there is a clear next step if it does.

A second episode, or quinsy sitting on top of frequent tonsillitis that is disrupting work, school, or sleep, is the point at which removing the tonsils is worth discussing. That decision belongs with an ENT specialist, who will weigh how often episodes happen, how severe they are, and your own circumstances. A GP's job is to document the pattern properly and make the ENT referral with a complete history attached, and that part is well suited to a bulk billed telehealth consultation.

The short version, if you take nothing else

One-sided severe throat pain, a jaw that will not open, a muffled voice, and drooling is a combination that goes to hospital today. Everything else on this page, the triage beforehand, the certificates, the antibiotic follow-up, the ENT referral if it happens again, is what a bulk billed telehealth GP can help with around that. If you are in the unsure middle and want a fast opinion on a sore throat, you can book a bulk billed telehealth consultation with an AHPRA-registered GP, and if you need to be seen in person, the GP will say so plainly.