Acute Pharyngitis Acute Pharyngitis

The infection appears The infection appears pharyngeal lymphoid pharyngeal lymphoid tissue tissue

The organism involved are similar The organism involved are similar predominantly tonsiler infection predominantly tonsiler infection

Causative organism in viral pharyngitis Causative organism in viral pharyngitis Rhinoviruses Rhinoviruses Coronaviruses Coronaviruses Influenza A and B Viruses Influenza A and B Viruses Adenoviruses Adenoviruses

When the symptoms * Fever * Malaise

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

Pharyngitis

COMPLICATIONS 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

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)

Abnormallities

Indications for Adenoidectomy Indications for Adenoidectomy Nasal Obstruction Nasal Obstruction Otitis media Otitis media Slep apnoea Slep apnoea

Contraindication to adenoidectomy Contraindication to adenoidectomy Upper respiratory tract infectionUpper respiratory tract infectionBleeding Bleeding

• Sepsis • Persisting deafness• Middle ear infection

Complications of Adenoidectomy

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) ACUTE LARYNGO TRACHEO BRONCHITIS

Sometimes referred :* acute laryngotracheitis* acute obstructive subglottic laryngitis

Call group (virus infection)

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 Clinical Features – Patient temperature sometimes rises to about 38,5Patient temperature sometimes rises to about 38,50 0 cc– Dry and harsh cough Dry and harsh cough – HoarsenessHoarseness– Stridor inspiratoar Stridor inspiratoar

Initial phase : Initial phase :

The child sometimes cyanoticThe child sometimes cyanotic

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

TREATMENT : TREATMENT : Antibiotics (a broad –spectrum penicillin)Antibiotics (a broad –spectrum penicillin) Corticosteroids Corticosteroids inflammatory reaction inflammatory reaction Mucolytic agentsMucolytic agents

Problems of a serious mature will only occur Problems of a serious mature will only occur

admission to hospital is delayed admission to hospital is delayed

Intubation and tracheostomy Intubation and tracheostomy

Performed for relief : Performed for relief : Airway obstruction Airway obstruction Facilitate bronchial toilet Facilitate bronchial toilet Assist ventilation Assist ventilation

Intubation difficulties from three sources : Intubation difficulties from three sources : a.a. Errors of techniques Errors of techniques b.b. Anatomical variations Anatomical variations c.c. Transient physiological and structural Transient physiological and structural

abnormalities abnormalities

Tracheostomy Tracheostomy

Indications Indications 1.1. Ventilatory insufficiencyVentilatory insufficiency2.2. Mechanical respiratory insufficiencyMechanical respiratory insufficiency3.3. Upper airway obstruction Upper airway obstruction

Complication of tracheostomy Complication of tracheostomy Immediate Immediate

• HaemorrhageHaemorrhage• Air embolism Air embolism • Apnoea Apnoea • Cardiac arrest Cardiac arrest

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

Late Stenosis trachea

Difficulty with decannulation