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==Overview==
==Overview==
Patients with adenoiditis are usually good-appearing. Physical examination of patients with adenoiditis is usually remarkable for fever, and purulent nasal discharges.<ref name="pmid25950686">{{cite journal |vauthors=Kosikowska U, Korona-Głowniak I, Niedzielski A, Malm A |title=Nasopharyngeal and Adenoid Colonization by Haemophilus influenzae and Haemophilus parainfluenzae in Children Undergoing Adenoidectomy and the Ability of Bacterial Isolates to Biofilm Production |journal=Medicine (Baltimore) |volume=94 |issue=18 |pages=e799 |year=2015 |pmid=25950686 |pmc=4602522 |doi=10.1097/MD.0000000000000799 |url=}}</ref><ref name="pmid27605988">{{cite journal |vauthors=Kajan ZD, Sigaroudi AK, Mohebbi M |title=Prevalence and patterns of palatine and adenoid tonsilloliths in cone-beam computed tomography images of an Iranian population |journal=Dent Res J (Isfahan) |volume=13 |issue=4 |pages=315–21 |year=2016 |pmid=27605988 |pmc=4993058 |doi= |url=}}</ref><ref name="pmid17883191">{{cite journal |vauthors=Galli J, Calò L, Ardito F, Imperiali M, Bassotti E, Fadda G, Paludetti G |title=Biofilm formation by Haemophilus influenzae isolated from adeno-tonsil tissue samples, and its role in recurrent adenotonsillitis |journal=Acta Otorhinolaryngol Ital |volume=27 |issue=3 |pages=134–8 |year=2007 |pmid=17883191 |pmc=2640046 |doi= |url=}}</ref>


== Physical exam ==
== Physical exam ==


===Appearance of the Patient===
===Appearance of the Patient===
*Patient is usually well-appearing in early stages, but may be ill appearing if the complications and disease severity are present.
*Patient is usually good-appearing in early stages, but may be ill appearing if the complications and disease severity are present.
===Vital Signs===
===Vital Signs===
*Fever
*Fever
*[[Tachycardia]] can be present as a
*[[Tachycardia]] can be present as a result of infection or pneumonia
*[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse
*[[Tachypnea]] can be present as a result of infection or pneumonia
*Tachypnea / bradypnea
*Kussmal respirations may be present in _____ (advanced disease state)
*Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
*High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]]
===HEENT===
===HEENT===
*Abnormalities of the head/hair may include ___
*[[Otoscopy|Otoscopic]] examination of the ears may reveal the following signs indicative of concurrent otitis media:<ref name="pmid25213276">{{cite journal |vauthors=Rettig E, Tunkel DE |title=Contemporary concepts in management of acute otitis media in children |journal=Otolaryngol. Clin. North Am. |volume=47 |issue=5 |pages=651–72 |year=2014 |pmid=25213276 |pmc=4393005 |doi=10.1016/j.otc.2014.06.006 |url=}}</ref>
*Evidence of trauma
**[[Erythema]] of the [[middle ear]]
*Icteric sclera
**Presence of purulent effusion<ref name="pmid23346249">{{cite journal |vauthors=Parlea E, Georgescu M, Calarasu R |title=Tympanometry as a predictor factor in the evolution of otitis media with effusion |journal=J Med Life |volume=5 |issue=4 |pages=452–4 |year=2012 |pmid=23346249 |pmc=3539835 |doi= |url=}}</ref>
*[[Nystagmus]]
**Bulging of the [[tympanic membrane]] in otitis media with effusion
*Extra-ocular movements may be abnormal
**Cloudy appearance of the [[tympanic membrane]]
*Pupils non-reactive to light / non-reactive to accomodation / non-reactive to neither light nor accomodation
**Immobility of the [[tympanic membrane]]
*Ophthalmoscopic exam may be abnormal with findings of ___
**[[Tympanic membrane]] perforation
*Hearing acuity may be reduced
*[[Purulent]] exudate from nose can be present as a result of concurrent sinusitis
*[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
*Facial and [[Maxilla|maxillary tenderness]] can be present as a result of concurrent [[sinusitis]] or the acute adenoiditis itself
*[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
*[[Erythematous]] throat with tonsillar swelling, exudates, and/or petechiae
*[[Exudate]] from the ear canal
*Oral mucous may be dry with ulcers due to mouth breathing
*Tenderness upon palpation of the ear pinnae / tragus (anterior to ear canal)
*Inflamed nares / congested nares
*[[Purulent]] exudate from the nares
*Facial tenderness
*Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
===Neck===
===Neck===
*[[Jugular venous distension]]
*[[Lymphadenopathy]] of cervical nodes
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
*[[Thyromegaly]] / thyroid nodules
*[[Hepatojugular reflux]]
===Lungs===
===Lungs===
*Asymmetric chest expansion / Decreased chest expansion
*Fine [[crackles]] upon auscultation of the lung due to concurrent pneumonia
*Lungs are hypo/hyperresonant
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
*Rhonchi
*Vesicular breath sounds / Distant breath sounds
*Expiratory/inspiratory wheezing with normal / delayed expiratory phase
*[[Wheezing]] may be present
*[[Egophony]] present/absent
*[[Bronchophony]] present/absent
*Normal/reduced [[tactile fremitus]]


==References==  
==References==  
{{Reflist|2}}
{{Reflist|2}}
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Otolaryngology]]
[[Category:Pediatrics]]
[[Category:Pulmonology]]
[[Category:Emergency medicine]]
[[Category:Infectious disease]]
[[Category:Surgery]]

Latest revision as of 20:18, 29 July 2020

Adenoiditis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Adenoiditis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

Overview

Patients with adenoiditis are usually good-appearing. Physical examination of patients with adenoiditis is usually remarkable for fever, and purulent nasal discharges.[1][2][3]

Physical exam

Appearance of the Patient

  • Patient is usually good-appearing in early stages, but may be ill appearing if the complications and disease severity are present.

Vital Signs

  • Fever
  • Tachycardia can be present as a result of infection or pneumonia
  • Tachypnea can be present as a result of infection or pneumonia

HEENT

Neck

Lungs

  • Fine crackles upon auscultation of the lung due to concurrent pneumonia

References

  1. ↑ Kosikowska U, Korona-Głowniak I, Niedzielski A, Malm A (2015). "Nasopharyngeal and Adenoid Colonization by Haemophilus influenzae and Haemophilus parainfluenzae in Children Undergoing Adenoidectomy and the Ability of Bacterial Isolates to Biofilm Production". Medicine (Baltimore). 94 (18): e799. doi:10.1097/MD.0000000000000799. PMC 4602522. PMID 25950686.
  2. ↑ Kajan ZD, Sigaroudi AK, Mohebbi M (2016). "Prevalence and patterns of palatine and adenoid tonsilloliths in cone-beam computed tomography images of an Iranian population". Dent Res J (Isfahan). 13 (4): 315–21. PMC 4993058. PMID 27605988.
  3. ↑ Galli J, Calò L, Ardito F, Imperiali M, Bassotti E, Fadda G, Paludetti G (2007). "Biofilm formation by Haemophilus influenzae isolated from adeno-tonsil tissue samples, and its role in recurrent adenotonsillitis". Acta Otorhinolaryngol Ital. 27 (3): 134–8. PMC 2640046. PMID 17883191.
  4. ↑ Rettig E, Tunkel DE (2014). "Contemporary concepts in management of acute otitis media in children". Otolaryngol. Clin. North Am. 47 (5): 651–72. doi:10.1016/j.otc.2014.06.006. PMC 4393005. PMID 25213276.
  5. ↑ Parlea E, Georgescu M, Calarasu R (2012). "Tympanometry as a predictor factor in the evolution of otitis media with effusion". J Med Life. 5 (4): 452–4. PMC 3539835. PMID 23346249.
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