Pharyngitis physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Pharyngitis}} | {{Pharyngitis}} | ||
{{CMG}}; {{AE}}{{VSKP}} | {{CMG}}; {{AE}} {{VSKP}} | ||
== Overview == | == 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 [[Group A streptococcal infection|GAS]]. | 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 == | == Physical Examination == | ||
=== Vital Signs === | === Vital Signs === | ||
* High/ low grade fever | * High/ low-grade [[fever]] | ||
=== Skin === | === Skin === | ||
* [[Scarlet Fever|Scarlatiniform rash]] associated with [[Group A streptococcal infection|GAS]], [[Arcanobacterium haemolyticum]] | * [[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 === | === HEENT === | ||
[[File:File: | '''Viral pharyngitis''' | ||
* Pharynx shows erythema, hypertrophy, tonsilar exudates, masses, Soft-palate petechiae (“doughnut” lesions), and beefy red, swollen uvula associate with | |||
* 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.<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> | [[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. | * 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]]. | * 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 === | ||
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=== Abdomen === | === Abdomen === | ||
* Hepatospleenomegaly: | * Hepatospleenomegaly: associate with pharyngitis caused by [[group A streptococcus]], [[infectious mononucleosis]] | ||
=== Neck === | === Neck === | ||
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==Reference== | ==Reference== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Needs content]] | [[Category:Needs content]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Inflammations]] | [[Category:Inflammations]] | ||
[[Category:Otolaryngology]] | [[Category:Otolaryngology]] | ||
[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Pediatrics]] | |||
[[Category:Immunology]] | |||
[[Category:Gastroenterology]] | |||
Latest revision as of 20:48, 9 December 2020
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Pharyngitis Microchapters |
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Pharyngitis physical examination On the Web |
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Risk calculators and risk factors for Pharyngitis physical examination |
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]
HEENT
Viral pharyngitis
Streptococcal pharyngitis
Diphtherial pharyngitis
- 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.
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