Podcast
Questions and Answers
What is a key consideration in managing acute epiglottitis?
What is a key consideration in managing acute epiglottitis?
What is a characteristic feature of peritonsillar abscess?
What is a characteristic feature of peritonsillar abscess?
What is a common causative organism of peritonsillar abscess?
What is a common causative organism of peritonsillar abscess?
What is a characteristic symptom of acute epiglottitis?
What is a characteristic symptom of acute epiglottitis?
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What is a key aspect of diagnosing peritonsillar abscess?
What is a key aspect of diagnosing peritonsillar abscess?
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What is a common complication of acute epiglottitis?
What is a common complication of acute epiglottitis?
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What is the primary cause of bacterial infection in acute epiglottitis?
What is the primary cause of bacterial infection in acute epiglottitis?
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What is the diagnostic sign on a lateral radiograph of the neck in acute epiglottitis?
What is the diagnostic sign on a lateral radiograph of the neck in acute epiglottitis?
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What is the age group that was most commonly affected by acute epiglottitis in the past?
What is the age group that was most commonly affected by acute epiglottitis in the past?
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What has decreased the incidence of acute epiglottitis?
What has decreased the incidence of acute epiglottitis?
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What is a complication of retropharyngeal abscess?
What is a complication of retropharyngeal abscess?
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What is a symptom of primary HIV infection?
What is a symptom of primary HIV infection?
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What is a non-infectious cause of pharyngeal pain?
What is a non-infectious cause of pharyngeal pain?
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What is a type of cancer that can present with pharyngeal pain?
What is a type of cancer that can present with pharyngeal pain?
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What is the most likely diagnosis for a patient with a sore throat, fever, and medial displacement of the uvula, palatine tonsil, and anterior pillar?
What is the most likely diagnosis for a patient with a sore throat, fever, and medial displacement of the uvula, palatine tonsil, and anterior pillar?
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What is the peak incidence age for retropharyngeal abscess?
What is the peak incidence age for retropharyngeal abscess?
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What is the best way to confirm a diagnosis of peritonsillar abscess?
What is the best way to confirm a diagnosis of peritonsillar abscess?
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What is the treatment for a retropharyngeal abscess?
What is the treatment for a retropharyngeal abscess?
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What is the temperature above which a fever is considered?
What is the temperature above which a fever is considered?
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What symptom is strongly suggestive of an infectious cause of pharyngitis?
What symptom is strongly suggestive of an infectious cause of pharyngitis?
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Study Notes
Airway Management
- Airway management is crucial to prevent airway compromise
- May require intubation
- Requires antibiotic therapy
Acute Epiglottitis
- Acute onset fever, severe sore throat, toxic appearance
- The 4 Ds: dysphagia, drooling, dysphonia, and distress
- Do not use a tongue depressor when examining the oropharynx as it can precipitate airway obstruction
Peritonsillar Abscess
- Also known as quinsy
- Most common deep infection of head and neck (30% of abscesses)
- Most common in young adults (ages 20-40); increased risk in immunocompromised and diabetics
- Begins as acute tonsillitis → cellulitis → abscess formation
- Polymicrobial infection with common organisms including Group A streptococci, Staphylococcus aureus, and Haemophilus influenzae
- Clinical presentation: severe unilateral sore throat, dysphagia, fever, and malaise
- Diagnosis can be made clinically without labwork/imaging in patients with typical presentation
- Oropharyngeal exam: erythematous enlarged tonsil and bulging soft palate on affected side, uvular deviation to contralateral side
- May have severely tender cervical lymphadenopathy
Retropharyngeal Abscess
- Retropharyngeal edema due to cellulitis and suppurative adenitis of lymph nodes in retropharyngeal space
- Preceded by upper respiratory infection, pharyngitis, otitis media, or wound infection following penetrating injury to posterior pharynx
- Peak incidence in 3-5 year olds
- Observed as prevertebral soft-tissue thickening on lateral X-ray of neck
- Treat as impending airway emergency
- Requires antibiotic therapy, possible surgical consultation for needle aspiration or incision and drainage
Clinical Presentation of Retropharyngeal Abscess
- Sore throat and dysphagia
- Fever
- Drooling
- Dysphonia (muffled voice)
- Neck stiffness; limited neck ROM (especially hyperextension)
- Stridor
- May see bulging of the posterior wall of oropharynx on clinical examination
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Description
A quiz on the clinical presentation and management of acute epiglottitis, a life-threatening condition that requires prompt recognition and treatment.
