Epiglottis, Quinsy, Pharyngitis, Tonsilitis, Ludwig's Angina ☺️ Flashcards
Epiglottis
- causative organism
- common in
- presentation
- investigations and diagnosis
- management
HiB - less common in children due to vaccinations
Rapid onset Fever, systemically unwell Stridor Drooling Tripod
Diagnosis - direct visualisation
Xray (L) - thumb sign - swollen epiglottis
Xray (PA) - steeple sign - subglottic narrowing
IMMEDIATE ENT, ANAESTHETIST INVOLVEMENT DUE TO HIGH RISK OF AIRWAY OBSTRUCTION
-O2, IV ABx
Tonsilitis
- causative organism and mimics
- common in
- presentation
- investigations and diagnosis
- management
- complications
Strep pyogenes, could be EBV (assess splenomegaly, longer duration)
Children and teens
Pharyngitis, fever, fatigue, lymphadenopathy
Purulent red enlarged tonsils
If bacterial => penicilins
-supportive, analgesia
Otitis media
Quinsy
Quinsy
- presentation
- managament
Complication of bacterial tonsilitis
- severe sore throat, worse on one side => ear pain
- uvula deviates to unaffected side
- difficulty opening mouth (trismus)
- reduced neck mobility
URGENT ENT REFERRAL
- drain abscess + IV ABx
- tonsilectomy to prevent recurrence
Ludwig’s angina
- risk factors
- presentation
- diagnosis and investigations
- management
Bacterial infection (staph/strep) under tongue
- poor dental hygiene
- mouth trauma/recent dental work
Pain, tenderness Difficulty swallowing => drooling Difficulty speaking Neck swelling => difficulty breathing Systemically unwell
Clinical diagnosis
- confirm severity with CT or MRI
- bacterial culture
A-E - AIRWAY MANAGEMENT
IV ABx
Abscess drainage
Retropharyngeal abscess
- risk factors
- presentation
- diagnosis and investigations
- management
Infection at back wall of throat
- ear, throat, sinus infection
- recent neck/throat injury
Fever, pain on swallowing, lymphadenopathy =>
- drooling
- cannot swallow, eat drink, open mouth
- hoarse voice, difficulty breathing
Clinical diagnosis => ENT referral
A-E - AIRWAY MANAGEMENT
IV ABx
Abscess drainage
