Acute Pharyngitis

The infection appears pharyngeal lymphoid tissue The organism involved are similar predominantly tonsiler infection Causative organism in viral pharyngitis Rhinoviruses Coronaviruses Influenza A and B Viruses Adenoviruses

When the symptoms * Fever

* Malaise

Pharyngitis
Influenza Diagnosed

Most Children and adult often accur in epidemics Spread of viruses droplet infection

Clinical features Sore throat Initial symptoms Malaise, fever and headache Cervical lymphadenopathy Hoarseness Secretion (Nasal cavities) hyperaemic congested turbinates nasopharynx hyperaemic Mucosa covered mucopus SELF LIMITING (3 OR 4 DAYS) TREATMENT : Symptomatic (Bed Rest, analgesics, antiviral agents) Antibiotics bacterial complication

COMPLICATIONS
Local
Sinusitis, otitis media, laryngitis, tracheobronchitis and pneumonia Respiratory obstruction (children)

General
Meningitis Encephalitis Myocarditis

Adenoid hypertrophy

The erlargement Inflamatory Symptoms : Not from the actual size of the lymphoid mass adenoid disproportion size
Cavity of the nasopharynx

Nasal obstruction Noisy respirations

 Older Children

Nasal obstruction mouth bresthing (abnormal) Adenoid facies It is generally enlarged - adenoid - dental - maxillary Other symptom deafness

Abnormal lities

Clinical Features Posterior rhinoscopy lobulated mass = Colour As the mucous membrane (nasopharynx)

DIAGNOSIS Palpate the postnasal space removed Anterior rhinoscopy should be carried out (Nasal obstruction) TREATMENT : Surgical (adenoidectomy)

Indications for Adenoidectomy

Nasal

Obstruction Otitis media Slep apnoea

Contraindication to adenoidectomy Upper respiratory tract infection Bleeding

Complications of Adenoidectomy
Sepsis Persisting deafness Middle ear infection

Acute Epiglottitis

More commonly in children Is a distinct form of acute inflammation of the larynx Aetiology : Haemophilus influenzae type B

Clinical Features

The history upper respiratory tract infection Sepsis (400 c) Potentially fatal stridor The epiglottis rounded swollen red mass (Inflammation and oedema of the supraglottic structures)

TREATMENT

Should be considered a surgical emergency Airway obstruction (intubation / tracheostomy) Sometimes referred : * acute laryngotracheitis * acute obstructive subglottic laryngitis Call group (virus infection)

ACUTE LARYNGO TRACHEO BRONCHITIS

 Aetiology
Microorganisms commonly involve in respiratory infections Predominant haemolytic streptococcus Usually infection by the influenza virus

Pathology
Affects the entire respiratory tract Total obstruction atelectasis

 Clinical Features
Patient temperature sometimes rises to about 38,50 c Dry and harsh cough Hoarseness Stridor inspiratoar

Initial phase :
The child sometimes cyanotic

Examination : - the pharynx and the larynx may be congested TREATMENT :

Antibiotics (a broad spectrum penicillin) Corticosteroids inflammatory reaction Mucolytic agents

Problems of a serious mature will only occur admission to hospital is delayed

Intubation and tracheostomy

Performed for relief :

Airway obstruction Facilitate bronchial toilet Assist ventilation

Intubation difficulties from three sources :

a. b.

c.

Errors of techniques Anatomical variations Transient physiological and structural abnormalities

Tracheostomy

Indications
1. Ventilatory insufficiency 2. Mechanical respiratory insufficiency 3. Upper airway obstruction

Complication of tracheostomy Immediate

Haemorrhage Air embolism Apnoea Cardiac arrest

 Intermediate

Displacement of the tube Infection Tracheal necrosis Tracheo oesophageal fistula Pneumothorax / pneumomediastinum

Late

Stenosis trachea Difficulty with decannulation