ENT Flashcards
What are dangerous causes of sore throat?
Epiglottitis
peritonsillar abscess
retropharyngeal abscess
Ludwig angina
what age group are retropharyngeal abscesses common in?
2-4
predmoninant bacteria that cause retropharyngeal abscess
polymicrobial: streptococcus pyogenes (GAS), staph aureus, anaerobes
Symptoms of retropharyngeal abscess
dysphagia, (difficulty swallowing) pain with swallowing (odynophagia), drooling unwilling to move neck muffled voice respiratory distress
Do symptoms of retropharyngeal abscess or epiglottitis tend to progress more quickly?
epiglottitis
Labs to get for suspected retropharyngeal infection
CBC (include anaerobic cultures),
will typically have WBC>12,000 with predominance of neutrophils and bands
imaging to get for retropharyngeal abscess
lateral neck radiographs or CT w/ contrast
Tx for retropharyngeal abscess
Need ENT consult- need surgical drainage w/ airway compromise, ab if airway not compromised (abscess >3 cm need drainage)
bilateral infection of the submandibular space that consists of two compartments in the floor of the mouth, the sublingual space and the submylohyoid (
Ludwig angina (submandibular space infection)
what typically causes ludwig angina?
infected second or third mandibular molar tooth
presentation with Ludwig angina
fever, chills, malaise, mouth pain, stiff neck, drooling, dysphagia, muffled voice. Typically no trismus
Imgaing for ludwig angina
CT
PE findings w/ ludwig angina
tender, symmetric, and “woody” induration, sometimes w/ palpable crepitus on the submandibular area. Mouth held open by lingual swelling
Tx for Ludwig angina
empiric broad spectrum abx, airway management
Gold standard for dx of GABS phayrngitits
throat cultures
