throat infections Flashcards
what is pharngitis
simple sore throat
pharyngitis causes
usually viral (adenovirus, rhinovirus)
pharyngitis presentation
- upper respiratory tract infection -> cough, nasal congestion and rhinorrhoea
- on examination -> tonsils look normal
pharyngitis management
rest and analgesia
what is tonsillitis
throat infection that involves palatine tonsils
tonsillitis causes
- usually viral
- bacterial causes -> group A strep, H. influenzae
name 5 tonsillitis complications
- sinusitis
- otitis media
- scarlet fever
- peritonsillar abscess (Quinsy)
- post-infective glomerulonephritis
scarlet fever presentation
- usually occurs within 3 weeks
- strawberry tongue
- red and rough textured rash on armpits, chest and groin that’s worse in the skin folds
scarlet fever management
antibiotics
peritonsillar abscess (Quinsy) presentation
- odynophagia
- hot potato voice
- trismus
- on examination -> unilaterally large tonsil with deviation of uvula
peritonsillar abscess (Quinsy) management
IV antibiotics and surgical drainage, tonsillectomy considered in 6 weeks
tonsillitis presentation
- sore throat
- halitosis
- dysphagia (and possible odynophagia)
- earache -> referred pain for CN IX
- bacterial infection -> more severe symptoms and more likely to result in missing school/work
- on examination -> enlarged tonsils with possible exudate (-> more likely to be bacterial)
what is Centor Criteria
- used to determine likelihood of bacterial infection and need for antibiotics
- fever, no cough, enlarged tonsils with exudate, tender anterior cervical lymphadenopathy
- score > 3 -> bacterial infection more likely -> antibiotics
tonsillitis management (viral)
bed rest, hydration and analgesia
tonsillitis management (bacterial, able to swallow)
- 1st line: penicillin
- 2nd line: clarithromycin
tonsillitis management (bacterial, unable to swallow)
- 1st line: benzylpenicillin
- 2nd line: clarithromycin
tonsillectomy complications
pain, bleeding and infection
indication for tonsillectomy
- > 7 episodes in one year
- > 5 episodes per year in 2 consecutive years
- > 3 episodes per year in 3 consecutive years
infectious mononucleosis (glandular fever) causes
- Epstein Barr Virus
- can also be caused by cytomegalovirus and HHV 6
what should patients with infectious mononucleosis avoid immediate return to contact sports
risk of splenic rupture
infectious mononucleosis presentation
sore throat and
- fatigue, malaise and lethargy
- transient macular rash
- petechial rash on palate
- lymphadenopathy for > 4 weeks
- associated with hepatitis, splenomegaly and anaemia
- on examination -> bilateral tonsillar enlargement with membranous exudate and possible hepatosplenomegaly
infectious mononucleosis diangosis
- blood film showing atypical lymphocytes
- positive monospot
- Paul Burnell test
infectious mononucleosis management
- supportive
- antibiotics not indicated
what will the use of ampicillin containing antibiotics (e.g. amoxicillin) cause in patients with infectious mononucleosis
widespread, generalised macro-papular rash
