Upload
frabzi
View
240
Download
0
Embed Size (px)
Citation preview
8/13/2019 8 - Sore Throat
1/26
SORE THROAT
Done by :
Firas kafawi
8/13/2019 8 - Sore Throat
2/26
SORE THROAT
A condition characterized by pain or
discomfort on swallowing.
It is a symptom of a wide variety of mild to
serious diseases, disorders andconditions. Could result from: URTI,
adenoid disorders, tonsillitis, allergy,
laryngitis, pharyngitis, trauma, GERD,
malignancy, AW obstruction and other
abnormal processes.
Can occur in any age group or population.
8/13/2019 8 - Sore Throat
3/26
Cont
Depending on the cause, a sore throat can
be short-term and disappear quickly or
chronic and ongoing over a long period of
time.
A sore throat often occurs in conjunction
with other symptoms such as fever,
swallowing difficulties, swollen
glandsetc.
8/13/2019 8 - Sore Throat
4/26
Cont
Diagnosis depends on History and
physical examination and lab tests.
Treatment of a sore throat involves
diagnosing and treating the underlyingdisease, disorder or condition causing it.
Drink warm liquids, honey or lemon tea
can help.
8/13/2019 8 - Sore Throat
5/26
TONSILLITIS
8/13/2019 8 - Sore Throat
6/26
8/13/2019 8 - Sore Throat
7/26
8/13/2019 8 - Sore Throat
8/26
WALDEYER'S TONSILLAR RING, CONSISTING OF AN UNPAIRED
PHARYNGEAL TONSIL IN THE ROOF OF THE PHARYNX, PAIRED
PALATINE TONSILS AND LINGUAL TONSILS SCATTERED IN THE
ROOT OF THE TONGUE.
8/13/2019 8 - Sore Throat
9/26
Tonsillitis
It is inflammation of the palatine tonsils.
Acute vs. Chronic.
Can occur in any age but more commonly
in children < 9 years old.
Spread by droplet infection.
Commonest in winter and spring.
3/10/2010 9
8/13/2019 8 - Sore Throat
10/26
Etiology
Viral (most common)
adenovirus, rhinovirus ,influenza
Bacterial (2ndm.comm.)- GABHS
- Others (s.aureus, strep.pn, mycoplasma.pn,
chlamydia.pn)less common
8/13/2019 8 - Sore Throat
11/26
Symptoms
Sore throatmay last >48 h.
Dysphagia and odynophagia.
Malaise.
Headache. Otalgia referred pain.
Halitosis.
Voice changes.
8/13/2019 8 - Sore Throat
12/26
Signs
Enlarged tonsils and hyperemic +/-
exudate pus.
Pharyngeal wall inflamed.
Pyrexia
may lead to febrile convulsionsin susceptible infants.
Tender and enlarged cervical lymph nodes
especially jugulodigastric.
8/13/2019 8 - Sore Throat
13/26
8/13/2019 8 - Sore Throat
14/26
Acute tonsillitis DDx
Infect ion
- Acute tonsillitis
- Infectious mononucleosis
- Diphtheria
- Vincent's angina
Neoplasm- Squamous cell carcinoma of the
tonsil
- Lymphoma
- Salivary gland tumours
Bloo d diseases- Agranulocytosis
- Leukaemia
Other causes- Aphthous ulcer
- Behcet's syndrome
- AIDS
There are several causes that may induce inflamedtonsils or ulceration:
8/13/2019 8 - Sore Throat
15/26
8/13/2019 8 - Sore Throat
16/26
Diphtheria
Very rare
insidious onset
characterized by a grey membrane
(difficult to remove) on the tonsils, faucesand uvula.
Pyrexia usually low and diagnosis is
confirmed by examination and culture of a
swab.
8/13/2019 8 - Sore Throat
17/26
Investigations
CBC.
Throat swabs.
ASO titre.
8/13/2019 8 - Sore Throat
18/26
Treatment
Aim of Tt:
- prevention of complications.
- symptomatic improvement.
- bacterial eradication.
- prevention of contamination.
- reducing unnecessary antibiotic use.
8/13/2019 8 - Sore Throat
19/26
Treatment
Bed rest.
Soft diet with fluid replacement.
Warm salt water gargle to relieve sore
throat. Analgesics and antipyretics.
Antibiotic in case of bacterial
- Penicillin 1stline.
- Erythromycinif allergy to penicillin. In case of viral cause, the length of illness depends
on the virus involved.
8/13/2019 8 - Sore Throat
20/26
Complications
Local :- peritonsillar abscess.
- retropharyngeal abscess.
- parapharyngeal abscess.- chronic tonsillitis.
Regional:- OM.
- laryngitis.
- bronchitis.
- GE.
- cervical lymphadenitis.
- Cavernous sinus thrombosis.
Systemic:- rheumatic fever.
- Acute GN.
- septicemia.- arthritis.
- scarlet fever (strep tonsillitis +
erythematous rash + strawberry
tongue)
Immune
complex
deposition 2
to strep.tonsil
8/13/2019 8 - Sore Throat
21/26
Peritonsillar abscess
(Quinsy)
Defini t ion:- collection of pus forming outside the capsule of the
tonsil in close relationship to its upper pole.
Etio logy:The infection spreads to the peritonsillar area (peritonsillitis).
This region comprises loose connective tissuesusceptible to
formation of abscess. Both aerobic and anaerobic bacteria can
be causative. Commonly involved species
include streptococci, staphylococciand hemophilus.
Epidemiology:- occur as complication of acute tonsillitis.
- more in adults (15-30) than in children.
http://en.wikipedia.org/wiki/Streptococcihttp://en.wikipedia.org/wiki/Staphylococcihttp://en.wikipedia.org/wiki/Hemophilushttp://en.wikipedia.org/wiki/Hemophilushttp://en.wikipedia.org/wiki/Staphylococcihttp://en.wikipedia.org/wiki/Streptococci8/13/2019 8 - Sore Throat
22/26
Clinical features
Fever, dehydration.
severe dysphagia
Edema of soft palate
Uvular deviation (downward and medially) Involvement of motor branch of CN V
increased salivation and trismus (Persistentcontraction of the masseter muscles due to failure of central
inhibition)
Hot potato voice
Unilateral referred otalgia
8/13/2019 8 - Sore Throat
23/26
8/13/2019 8 - Sore Throat
24/26
Complications
AW obstruction
Bacteremia
Aspiration pneumonia secondary to
rupture of abscess
8/13/2019 8 - Sore Throat
25/26
Treatment
IV antibioticswithout delay
surgical incision and drainage of pus
forming outside the capsule -- relieving the
pain dramatically.
Under general anesthesiain children
and anxious pts.
8/13/2019 8 - Sore Throat
26/26
THANK YOU