Pharyngitis physical examination: Difference between revisions

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Latest revision as of 20:48, 9 December 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]

Overview

Patients with pharyngitis typically have low-grade fever and pharyngeal erythema, suggestive of viral etiology or pharyngeal exudate or petechia, suggestive of group A streptococcus. Additional signs include enlarged edematous tonsils, enlarged and/or tender cervical adenopathy, rash may or may not be present. Scarlatiniform rash, which is marked by multiple small red papules that are widely and diffusely distributed but spare the palms and soles, is suggestive of GAS.

Physical Examination

Vital Signs

High/ low-grade fever

Skin

Scarlatiniform rash associated with GAS, Arcanobacterium haemolyticum^[1]

By The original uploader was Estreya at English Wikipedia - Transferred from en.wikipedia to Commons., CC BY 2.5, https://commons.wikimedia.org/w/index.php?curid=2050898

HEENT

Viral pharyngitis

CC BY-SA 2.5, https://commons.wikimedia.org/w/index.php?curid=960953

Streptococcal pharyngitis

By James Heilman, MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=11596322

Diphtherial pharyngitis

Diphtheria pharyngitis with pseudomembrane in the left side of posterior pharynx - By User:Dileepunnikri - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=27093567

Pharynx shows erythema, hypertrophy, tonsilar exudates, masses, Soft-palate petechiae (“doughnut” lesions), and beefy red, swollen uvula associate with Streptococcal pharyngitis.^[2]^[1]
Grayish brown diphtheritic pseudomembrane which may involve one or both tonsils or may extend widely to involve the nares, uvula, soft palate, pharynx, larynx, and tracheobronchial tree associate with Corynebacterium diphtheria.^[1]
Conjunctivitis and periauricular lymphadenopathy associate with adenoviral infection.
Blisters or ulcers in the anterior mouth or lips are seen in herpes simplex infection.

Public Domain, https://commons.wikimedia.org/w/index.php?curid=889537

Heart

Heart murmur associate with rheumatic fever due to streptococcal pharyngitis.

Abdomen

Hepatospleenomegaly: associate with pharyngitis caused by group A streptococcus, infectious mononucleosis

Neck

Cervical adenopathy

Reference

↑ ^1.0 ^1.1 ^1.2 Bisno AL (2001) Acute pharyngitis. N Engl J Med 344 (3):205-11. DOI:10.1056/NEJM200101183440308 PMID: 11172144
↑ Vincent MT, Celestin N, Hussain AN (2004) Pharyngitis. Am Fam Physician 69 (6):1465-70. PMID: 15053411

Template:WH Template:WS

[pmid11172144-1] 1.0 ^1.1 ^1.2 Bisno AL (2001) Acute pharyngitis. N Engl J Med 344 (3):205-11. DOI:10.1056/NEJM200101183440308 PMID: 11172144

[pmid15053411-2] Vincent MT, Celestin N, Hussain AN (2004) Pharyngitis. Am Fam Physician 69 (6):1465-70. PMID: 15053411

[1]

[2]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Pharyngitis}}
+{{CMG}}; {{AE}} {{VSKP}}
 == Overview ==
+Patients with pharyngitis typically have low-grade [[fever]] and pharyngeal [[erythema]], suggestive of [[viral]] etiology or pharyngeal exudate or [[petechia]], suggestive of [[group A streptococcus]]. Additional signs include [[Tonsillitis|enlarged edematous tonsils]], enlarged and/or tender [[Cervical lymph nodes|cervical adenopathy,]] [[rash]] may or may not be present. [[Scarlet Fever|Scarlatiniform rash]], which is marked by multiple small red [[papules]] that are widely and diffusely distributed but spare the [[palms]] and [[soles]], is suggestive of [[Group A streptococcal infection|GAS]].
+== Physical Examination ==
+=== Vital Signs ===
+* High/ low-grade [[fever]]
+=== Skin ===
+* [[Scarlet Fever|Scarlatiniform rash]] associated with [[Group A streptococcal infection|GAS]], [[Arcanobacterium haemolyticum]]<ref name="pmid11172144">Bisno AL (2001) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11172144 Acute pharyngitis.] ''N Engl J Med'' 344 (3):205-11. [http://dx.doi.org/10.1056/NEJM200101183440308 DOI:10.1056/NEJM200101183440308] PMID: [https://pubmed.gov/11172144 11172144]</ref>
+[[Image:Scarlet fever 2.jpg|400px|thumb|center|By The original uploader was Estreya at English Wikipedia - Transferred from en.wikipedia to Commons., CC BY 2.5, https://commons.wikimedia.org/w/index.php?curid=2050898]]
 === HEENT ===
-Pharynx shows erythema, hypertrophy, foreign body, exudates, masses, petechiae, and adenopathy.<ref name="pmid15053411">Vincent MT, Celestin N, Hussain AN (2004) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=15053411 Pharyngitis.] ''Am Fam Physician'' 69 (6):1465-70. PMID: [https://pubmed.gov/15053411 15053411]</ref>
+'''Viral pharyngitis'''
+[[File:Viral pharyngitis1.jpg|thumb|center|500px|CC BY-SA 2.5, https://commons.wikimedia.org/w/index.php?curid=960953]]
+'''Streptococcal pharyngitis'''
+[[File:Streptococcal Pharyngitis1.JPG|500px|thumb|center|By James Heilman, MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=11596322]]
+'''Diphtherial pharyngitis'''
+[[File:Diphtherial pharyngitis 1.jpg|center|frame|100px|Diphtheria pharyngitis with pseudomembrane in the left side of posterior pharynx - By User:Dileepunnikri - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=27093567]]
+* Pharynx shows [[erythema]], [[hypertrophy]], tonsilar exudates, masses, Soft-palate [[petechiae]] (“doughnut” lesions), and beefy red, swollen [[uvula]] associate with Streptococcal pharyngitis.<ref name="pmid15053411">Vincent MT, Celestin N, Hussain AN (2004) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=15053411 Pharyngitis.] ''Am Fam Physician'' 69 (6):1465-70. PMID: [https://pubmed.gov/15053411 15053411]</ref><ref name="pmid11172144">Bisno AL (2001) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11172144 Acute pharyngitis.] ''N Engl J Med'' 344 (3):205-11. [http://dx.doi.org/10.1056/NEJM200101183440308 DOI:10.1056/NEJM200101183440308] PMID: [https://pubmed.gov/11172144 11172144]</ref>
+* Grayish brown diphtheritic pseudomembrane which may involve one or both tonsils or may extend widely to involve the [[nares]], [[uvula]], [[soft palate]], [[pharynx]], [[larynx]], and [[tracheobronchial tree]] associate with [[Corynebacterium diphtheriae|Corynebacterium diphtheria]].<ref name="pmid11172144">Bisno AL (2001) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11172144 Acute pharyngitis.] ''N Engl J Med'' 344 (3):205-11. [http://dx.doi.org/10.1056/NEJM200101183440308 DOI:10.1056/NEJM200101183440308] PMID: [https://pubmed.gov/11172144 11172144]</ref>
+* Conjunctivitis and periauricular lymphadenopathy associate with [[adenoviral]] infection.
+* Blisters or ulcers in the anterior mouth or lips are seen in [[Herpes simplex virus|herpes simplex infection]].
+[[File:Herpes labialis - opryszczka wargowa.jpg|thumb|center|200px| Public Domain, https://commons.wikimedia.org/w/index.php?curid=889537]]
+=== Heart ===
+* Heart murmur associate with [[rheumatic fever]] due to streptococcal pharyngitis.
+=== Abdomen ===
+* Hepatospleenomegaly: associate with pharyngitis caused by [[group A streptococcus]], [[infectious mononucleosis]]
-'''Diphtheria:''' Examination reveals a serosanguineous nasal discharge and a grayish-white pharyngeal membrane (exudative and extending to the uvula and soft palate) in association with pharyngitis, tonsillitis, and cervical lymphadenopathy.<ref name="pmid15053411">Vincent MT, Celestin N, Hussain AN (2004) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=15053411 Pharyngitis.] ''Am Fam Physician'' 69 (6):1465-70. PMID: [https://pubmed.gov/15053411 15053411]</ref>
+=== Neck ===
+* Cervical adenopathy
 ==Reference==
 {{reflist|2}}
+{{WH}}
+{{WS}}
 [[Category:Needs content]]
 [[Category:Emergency medicine]]
-[[Category:Primary care]]
-[[Category:Infectious disease]]
 [[Category:Inflammations]]
 [[Category:Otolaryngology]]
 [[Category:Pulmonology]]
+[[Category:Emergency mdicine]]
-{{WH}}
+[[Category:Disease]]
-{{WS}}
+[[Category:Up-To-Date]]
+[[Category:Infectious disease]]
+[[Category:Pediatrics]]
+[[Category:Immunology]]
+[[Category:Gastroenterology]]