Pharyngitis differential diagnosis: Difference between revisions
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* [[Dysphagia]] without [[odynophagia]] which will differentiate it from pharyngitis. | * [[Dysphagia]] without [[odynophagia]] which will differentiate it from pharyngitis. | ||
* White plaques that reveal an erythematous base when scraped | * White plaques that reveal an erythematous base when scraped | ||
* Usually in immunocompromised patients, including those with | * Usually in [[immunocompromised]] patients, including those with advanced [[Human Immunodeficiency Virus (HIV)|HIV]]/AIDS | ||
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* [[Mononucleosis|Mononucleosisis]] caused by infection with [[Epstein Barr virus|Epstein-Barr virus]] | * [[Mononucleosis|Mononucleosisis]] caused by infection with [[Epstein Barr virus|Epstein-Barr virus]] | ||
* Usually, it presents with a classic triad of severe sore throat accompanied by [[fever]] and [[lymphadenopathy]] | |||
* Usually, it presents with a classic triad of severe sore throat accompanied by fever and lymphadenopathy | |||
* Other symptoms and signs include the following: | * Other symptoms and signs include the following: | ||
** Fatigue | ** Fatigue | ||
** Diffuse lymphadenopathy, particularly bilateral and posterior cervical | ** Diffuse lymphadenopathy, particularly bilateral and posterior cervical | ||
** Splenomegaly in 50% of cases | ** [[Splenomegaly]] in 50% of cases | ||
** Hepatomegaly in 10% of cases | ** [[Hepatomegaly]] in 10% of cases | ||
** Pharyngeal petechiae | ** Pharyngeal petechiae | ||
** Rash: 90% of patients will develop a pruritic, maculopapular rash after the use of ampicillin or amoxicillin | ** Rash: 90% of patients will develop a pruritic, [[maculopapular rash]] after the use of [[ampicillin]] or [[amoxicillin]] | ||
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* | * [[Epiglottitis]] is an inflammation of the epiglottis and adjacent structures that can be life-threatening caused by [[Hemophilus influenzae]] especially unimmunized children. | ||
* In adults, epiglottitis has widely varying presentations and symptoms: | * In adults, epiglottitis has widely varying presentations and symptoms: | ||
** Odynophagia (most commonly) | ** Odynophagia (most commonly) | ||
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* The classic tripod positioning (patient sits or stands leaning forward and supporting the upper body with hands on the knees), is seen only in 5% of cases | * The classic tripod positioning (patient sits or stands leaning forward and supporting the upper body with hands on the knees), is seen only in 5% of cases | ||
* If epiglottitis is suspected, immediate referral to the emergency department for airway management | * If epiglottitis is suspected, immediate referral to the emergency department for airway management | ||
* Diagnosis requires laryngoscopy | * Diagnosis requires [[laryngoscopy]] | ||
* | * If the patient is in respiratory distress, prompt intubation is required to maintain airway. | ||
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* Peritonsillar abscess is | * Peritonsillar abscess is the collection of pus behind the tonsil in the superior arch of the soft palate | ||
* | * It might develop as a complication of oropharyngeal infection, such as [[tonsillitis]] | ||
* | * The most common bacteria is [[Group A streptococcal infection|group A streptococci]], but the causative organism could be polymicrobial | ||
* Symptoms include fever, malaise, dysphagia, drooling, muffled or 'hot potato' voice, and referred ear pain | * Symptoms include fever, malaise, dysphagia, drooling, muffled or 'hot potato' voice, and referred ear pain. | ||
* Diagnosis is a combination of physical examination and imaging with computed tomography (CT) or ultrasonography | * Diagnosis is a combination of physical examination and imaging with computed tomography (CT) or ultrasonography | ||
* Management requires urgent referral to | * Management requires urgent referral to a specialist or surgeon for surgical drainage, in addition to antibiotic treatment. | ||
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Revision as of 15:28, 6 January 2017
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]
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Pharyngitis Microchapters |
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Overview
Pharyngitis should be differentiated from other infectious causes which mimic sore throat that includes oral thrush, infectious mononucleosis, epiglottitis and peritonsilar abscess.[1]
Differentiating Pharyngitis from other Diseases
The major goal of the differentiating patients with sore throat or acute pharyngitis is to exclude potentially dangerous causes (e.g. Group A streptococcus), to identify any treatable causes, and to improve symptoms. Identifying the treatable causes is important because timely treatment with antibiotics helps prevent complications such as acute rheumatic fever, post streptococcal glomerulonephritis.[2]
| Thrush | Mononucleosis | Epiglottitis | Peritonsillar abscess |
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References
- ↑ Vincent MT, Celestin N, Hussain AN (2004) Pharyngitis. Am Fam Physician 69 (6):1465-70. PMID: 15053411
- ↑ Del Mar CB, Glasziou PP, Spinks AB (2006) Antibiotics for sore throat. Cochrane Database Syst Rev (4):CD000023. DOI:10.1002/14651858.CD000023.pub3 PMID: 17054126