Pharynx inflammation

1. CLINICAL MEDICINE-
PHARYNGITIS

2. PHARYNGITIS-Sorethroat
This is inflammation of the oropharynx-
throat.
Classified into:
a) Acute pharyngitis
b) Chronic pharyngitis

3. ACUTE PHARYNGITIS
- May be an accompanying feature of local or
systemic diseases
i. May follow common cold
ii. May be an accompanying feature of
infections like measles, chicken pox or
influenza
iii. Can follow trauma by a foreign body like
fish bone and chicken bone

4. Symptoms:
- Sore throat
- Fever
- Chills
O/E
- Diffuse congestion of pharyngeal wall, uvula &
faucial pillars.
Treatment:
- Bed rest
- Analgesics
- Antibiotics – Penicillin, Erythromycin

5. MEMBRANOUS PHARYNGITIS
• This is pharyngitis associated with formation
of membrane in the pharynx
• Examples include:
– Faucial diphtheria
– Vincents angina
– Moniliasis (thrush)

6. CHRONIC PHARYNGITIS
May be due to
i) Non specific
ii) Specific lesions

7. NON SPECIFIC PHARYNGITIS
- This is due to aetiological factors in the nose
or oral cavity:
- (i)Infected discharge from the nose and
paranasal sinuses results in chronic
inflammatory changes
(ii)Obstructive lesions in the nose like DNS,
nasal polypi and adenoids lead to mouth
breathing which leads to pharyngitis.
- (iii) Dental caries may lead to pharyngeal
infection

8. - (iv) People working in dusty atmosphere
workers can develop chronic pharyngitis
- (v)Hyperacidity and chronic suppurative lung
diseases can lead to chronic pharyngitis.
Clinical Features:
- Discomfort in the throat with a foreign body
sensation, tendency to clear the throat,
- Tiredness in the voice
- odynophagia

9. On Examination
• There is diffuse congestion of the pharyngeal
wall
• Hypertrophy of lymph nodes on the
pharyngeal wall – granules picture-this form of
pharyngitis occurs in preachers who use their
voices excessively with faulty voice
production.

10. Treatment of Chronic Pharyngitis
- The primary aetiological factor in the nose,
nasopharynx(discharge) or oral cavity(dental
caries, gingivitis) should be addressed.
- Cough suppressants like codein phosphate
linctus should be given to relieve the cough
- Alcohol, smoking, irritants and spicy foods
should be avoided

11. TONSILLITIS
Classified into:
i. Acute tonsilitis
ii. Chronic tonsilitis
ACUTE TONSILLITIS
- Mainly a disease of childhood but it is also
frequently seen in adults.

12. AETIOLOGY
Common causative organisms include:
- Haemolytic streptococcus
- Staphylococci
- Haemophilus influenzae
Predisposing factors include;
- Poor orodental hygiene
- Poor nutrition
- overcrowding

13. CLINICAL FEATURES
- Patient presents with discomfort in the throat
- Difficulty in swallowing
- generalised body symptoms like malaise,
anorexia, fever, body aches.

14. On Examination
- Patient is febrile & has tachycardia
- The tonsils appear swollen congested with
exudate in the crypts
- The jugulodigastric lymph nodes are enlarged
and tender.

15. Treatment
- Bed rest
- Plenty of fluids- patient is dehydrated
- Analgesics
- Antibiotics – Penicillin, Erythromycin,
Ampicillin

16. Complications of Acute Tonsillitis
- Chronic tonsillitis
- Peritonsillar abscess
- Parapharyngeal abscess
- Acute otitis media
- Acute nephrites and rheumatic fever.

17. CHRONIC TONSILLITIS
- This is usually due to recurrent acute
infections treated inadequately.
Clinical features
Symptoms:
- Discomfort in the throat
- Unpleasant taste in the mouth(cacagus)
- Bad smell in the mouth(halitosis)
- Difficulty in swallowing
- Change in voice

18. On Examination:
- The tonsils appear hypertrophic, diffusely
congested
- Anterior faucial pillars are hyperaemic
- Sometimes the tonsils may be small & fibrotic
- There is enlargement of cervical lymphnodes

19. TREATMENT:
• Treatment of the predisposing factors such as
infections of the nose & paranasal sinuses
with
- antibiotics
- mucolytics
- antihistamines
And surgical management like septoplasty, AWO,
removal of nasal polyps
• If these fail, then tonsillectomy.

20. ADENOIDS
• Adenoids are hypertrophied nasopharyngeal
tonsils
• As the child grows the size of these
nasopharyngeal tonsils diminishes.

21. CLINICAL FEATURES
These include;
- Frequent attacks of cold
- Persistent nasal discharge
- Nasal obstruction
- Snoring
- Mouth breathing
- Headaches
- Nocturnal cough
- Poor appetite

22. On Examination:
- There is post nasal mucoid or mucopurulent
discharge
- Exam reveals mucoid or mucopurulent
discharge in the nose.
- A lateral Xray of the nasopharynx is done to
show adenoid mass.

23. Complications of Adenoids
- Recurrent attacks of otitis media
- Secretory otitis media
- Maxillary sinusitis.
Treatment:
- Decongestants – systemic and locally in the
nose.
- Systemic antibiotics
- Antihistamines
Surgery
- Adenoidectomy