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Final pharyngitis
- 1. Pharyngitis Presented By Dr. RajeshPandey 20 Nov. 2019
- 2. 2 Pharyngitis Definition Pharyngitis is inflammationof the pharynx, which is in the back of the throat.
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- 4. • The pharynxis divided in to three part • Nasopharynx • Oropharynx • Laryngopharynx Nasopharynx • The part of pharynx which lies above the soft palate & Behind the nasal cavity. Oropharynx • This part extends from the level of the soft palate to the level of laryngeal inlet. Laryngopharynx • This part lies behind the larynx & partially surrounds the larynx. Cont..
- 5. Type of Pharyngitis 1-Acute 2- Chronic
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- 9. Acute Pharyngitis Definition Acute inflammationof pharyngeal mucosa and submucosa, mostly invovled in pharyngeal lymphoid tissue.
- 10. Etiology • 1. Virus* •2. Bacteria* • 3. Environmental Factors*
- 11. Pathology • Acute inflammationof the pharyngeal mucosal tissue • Blood vessels dilatation • Inflammatory cells infiltration • Mucosal swelling.
- 12. Sign • Erythema • Enlargementof tonsils • Lymphoid follicles on the posterior pharyngeal wall • Oedema of soft palate and uvula. • Enlargement of cervical nodes.
- 13. Symptoms • Sore throat •Pain or difficulty when swallowing or talking • Swollen, sore glands in the neck or throat • Red throat and red, swollen tonsils • A hoarse voice.
- 14. Treatment • Gargle • Bedrest • More drink • Antiviral • Antibiotics
- 15. Chronic Pharyngitis Definition*: diffuse inflammationof pharyngeal mucosa and submucosa, and pharyngeal lymphoid tissue.
- 16. Chronic Pharyngitis- Etiology ViralAdenovirus • Influenza virus Bacterial –beta-hemolytic streptococci • H. influenza • Staphylococcus aureus • Diphtheria • Gonococcus Fungal – Candida albicans.
- 17. • Persistent infections-chronic rhino sinusitis with post nasal drip, chronic tonsillitis, dental sepsis, Mouth breathing-nasal polyp. • Allergic/vasomotor rhinitis, nasopharyngeal adenoids, tumors. • Chronic irritants -smoking, tobacco chewing, alcohol, highly spicy food. • Environmental-smoke, dust, chemicals, • occupational fumes. Chronic Pharyngitis- Etiology
- 18. Chronic Pharyngitis- signs •Catarrhal- congestion, increased secretions. • Hypertrophic-pharyngeal wall thick, edematous, congested mucosa and dilated vessels. • Posterior pharyngeal wall studded with reddish nodules- due to sub epithelial lymphoid follicle hypertrophy. • Uvula congested and elongated.
- 19. Chronic Pharyngitis- signs Chronichypertrophic (granular) pharyngitis • Pharyngeal wall appears thick • Pharyngeal wall edematous • Congested mucosa • Dilated vessels. • Posterior pharyngeal wall may be studded with reddish nodules. • Lateral pharyngeal bands become hypertrophied. • Uvula may be elongated and appear edematous.
- 20. Chronic catarrhal pharyngitis •Congestion of posterior pharyngeal wall with engorgement . of vessels. • Faucial pillars may be thickened. • Increased mucus secretion which may cover pharyngeal . mucosa. Cont..
- 21. Chronic Pharyngitis- symptoms •Discomfort, pain-more during morning. • Foreign body sensation-constant desire to swallow or clear throat. • Voice tiredness. • cough
- 22. Factors 1. Local Factors： •Repeat relapse of acute pharyngitis • Affected by adjacent organs ：nose, tonsils. • Bad irritants 2. General Factors： • General chronic diseases: anemia, dyspepsia, lower • Respiratory chronic diseases, cardiovascular diseases. • Allergic factors
- 23. A large numberof factors are responsible: 1. Persistent infection. • Chronic rhinitis • Sinusitis • Purulent discharge • Constantly trickles down the pharynx and • Provides a constant source of infection. • Causes hypertrophy of the lateral pharyngeal bands. 2. Chronic tonsillitis 3. Dental sepsis 4. Mouth breathing Factors
- 24. 5. Breathing throughthe mouth • Obstruction in the nose • Nasal polypi • Allergic rhinitis • Vasomotor rhinitis • Turbinate hypertrophy • Deviated septum • Tumours 6. Nsopharyngeal causes • Adenoids • Tumours . Cont..
- 25. 7. Chronic irritants. •Excessive smoking • Chewing of tobacco and pan • Heavy drinking, • Highly spiced food 8. Environmental pollution • Smoky • dusty environment • Irritant industrial 9. Faulty voice production • Excessive use of voice • Throat clearing • Hawking • Snorting Cont..
- 26. Transmission • Both viraland bacterial forms of pharyngitis are contagious. The germs that cause pharyngitis tend to live in the nose and throat. • When a person with the condition coughs or sneezes, they release tiny droplets that contain the virus or bacteria into the air. A person can become infected by: breathing these tiny droplets in. • Touching contaminated objects and then touching their face consuming contaminated food and beverages. • This is why it is essential for a person to wash their hands before handling food or touching their face. • People usually recover from viral infections, such as the common cold, within 7 to 10 days.
- 27. Physical Examination • Examinationof the oropharynx reveals an exudative pharyngitis with erythema and tonsillar hypertrophy , diffuse lymphoid hyperplasia of waldoyar`s ring, petechiae at the hard palate- soft palate junction, and ulcers on the pharyngeal and epiglottis mucosa.
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- 29. Clinical Manifestation Bacterial (Strep.) •Rapid onset • Headache • GI Symptoms • Sore throat • Erythma • Palatine petechiae • Enlarged tonsils • Anterior cervical adenopathy &Tender • Red& swollen uvula
- 30. Cont.. Viral • cough • headache •fever • body aches • sneezing • congestion in the nasal passageways • swollen lymph nodes • mouth ulcers • abdominal pain, especially on the upper left side • rash
- 31. Pathology • Chronic simplepharyngitis: chronic mucosal congestion, gland hypertrophy, hypersecretion. • Chronic hypertrophic pharyngitis: mucosal congestion, pharyngeal lymphoid tissue hypertrophy. • Atrophic pharyngitis and pharyngitis, hypo secretion, mucosa is thin.
- 32. • ESR, Hb,TLC & DLC • Total Serum Proteins • Serum Electrolytes • Throat swab • Endoscopy • X-ray • CT-Scan Investigation
- 33. Clinical Diagnosis • highprobability :empiric antibiotic therapy, • intermediate probability: further testing ( rapid antigen test) or (throat culture) • low probability: symptomatic therapy and appropriate follow-up
- 34. • Etiological factorsought and eradicated. • (Oily & Spicy food, Tobacco, Alcohol) • Voice rest. • Bed rest • Warm saline gargle • Analgesics. • Clindamycin • Augmentin Chronic Pharyngitis-treatment
- 35. Complications • Otitis media •Sinusitis • Peritonsillar and retropharyngeal abscesses • Suppurative cervical adenitis
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