module 3 peds pharyngitis, tonsillitis, tonsillopharyngitis Flashcards
pharyngitis
inflammation of the mucosa lining the structures of the throat
- tonsils
- pharynx
- uvula
- soft palate
- nasopharynx
causes of pharyngitis
infectious agents
non-infectious agents
- environmental
- allergic
- referred pain
- oncological causes
nasopharyngitis
pharyngitis with nasal s/s
pharyngitis/tonsillopharyngitis
no nasal symptoms
viruses that cause pharyngitis
adenovirus
epstein-barr virus
parainfluenza
influenza
HSV
cytomegalovirus
enterovirus
HIV
viral infection s/s
hoarseness
cough
coryza
conjunctivitis
diarrhea
rhinitis
stomatitis
stridor
nonspecific rash
bacterial causes of pharyngitis
GABHS
group C,G streptococci
M, C pneumoniae
A. haemolyticum
A. haemlyticum s/s
pharyngitis
fine, scarlatiniform rash
pruritus
fever
cough
mild or marked pharyngeal erythema
- with or without exudate/cervical adenopathy
pharyngitis s/s
pain
myalgia
arthralgia
fever
sore throat
dysphagia
GABHS s/s
usually 5-13 y/o
acute onset w/out nasal s/s
tender lymph nodes
arthralgia
myalgia
headache
moderate-high fever
malaise
prominent ST
dysphagia
N/V
abdominal discomfort
EBV physical exam
exudate on tonsils
soft palate petechiae
cervical lymphadenopathy
adenovirus s/s
pharyngoconjunctival fever
- fever
- pharyngitis
- rhinitis
- cervical lymphadenopathy
- bulbar and palpebral follicular conjunctivitis
enterovirus s/s
vesicles or ulcers on tonsillar pillars and posterior fauces
coryza
vomiting
diarrhea
Herpesvirus s/s
gum erythema
small erupted vesicles in mouth
marked adenopathy
parainfluenza and RSV s/s
lower resp. tract disease
- croup
- pneumonia
- bronchiolitis
stridor
rales
wheezing
influenza s/s
cough
fever
multiple systemic compliants
GABHS physical exam
- petechiae on soft palate and pharynx
- swollen beefy-red uvula
- red enlarged tonsillopharyngeal tissue
- tonsillopharyngeal exudate: yellow, blood-tinged
- tender, enlarged anterior cervical lymph nodes
- bad breath
- stigmata of scarlet fever
-> scarlatiniform rash, strawberry tongue, circumoral pallor
Testing for GABHS
> 3 years old with pharyngitis
management for viral infections
supportive care
GABHS managements
antibiotics when RADT/culture is positive
- must be initiated w/in 9 days to prevent rheumatic fever
- PCN
supportive care
GABHS return to school
afebrile and have been on abx for 12-24 hours
treating of carrier strep circumstances
- outbreak in a closed community
- family or personal hx of. rheumatic fever
- ping pong spread in family members for several weeks
- tonsillectomy is being considered
- local outbreak of rheumatic fever or invasive group A strep
nonsuppurative complications of strep pharyngitis
rheumatic fever
poststreptococcal reactive arthritis
sydenham chorea
acute glomerulonephritis
suppurative complications of strep pharyngitis
cervical adenitis
rhinosinusitis
otitis media
pneumonia
mastoiditis
retropharyngeal or peritonsillar abscess