Adenoiditis differential diagnosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Adenoiditis]] | |||
{{CMG}};{{AE}}{{MIR}} | {{CMG}};{{AE}}{{MIR}} | ||
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!Treatment | !Treatment | ||
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|[[Upper respiratory tract infection]] | |[[Upper respiratory tract infection]]<ref name="urlAntibiotics for adults with acute laryngitis | Cochrane Summaries">{{cite web |url=http://www.cochrane.org/reviews/en/ab004783.html |title=Antibiotics for adults with acute laryngitis | Cochrane Summaries |format= |work= |accessdate=}}</ref><ref>http://www.cochrane.org/reviews/en/ab004403.html Antibiotics for exacerbations of chronic obstructive pulmonary disease</ref><ref>http://www.cochrane.org/reviews/en/ab000980.html Vitamin C for preventing and treating the common cold</ref> | ||
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* [[Itchy]], watery eyes | * [[Itchy]], watery eyes | ||
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|Symptomatic therapy: | |Symptomatic therapy: | ||
* [[Decongestants]] | * [[Decongestants]] | ||
|- | |- | ||
|[[Peritonsillar abscess]] | |[[Peritonsillar abscess]]<ref name="pmid15635144">{{cite journal| author=Lyon M, Blaivas M| title=Intraoral ultrasound in the diagnosis and treatment of suspected peritonsillar abscess in the emergency department. | journal=Acad Emerg Med | year= 2005 | volume= 12 | issue= 1 | pages= 85-8 | pmid=15635144 | doi=10.1197/j.aem.2004.08.045 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15635144 }} </ref><ref name="pmid1642863">{{cite journal| author=Boesen T, Jensen F| title=Preoperative ultrasonographic verification of peritonsillar abscesses in patients with severe tonsillitis. | journal=Eur Arch Otorhinolaryngol | year= 1992 | volume= 249 | issue= 3 | pages= 131-3 | pmid=1642863 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1642863 }} </ref> | ||
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* Severe [[sore throat]] | * Severe [[sore throat]] | ||
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* [[Streptococcus pyogenes|Aerobic and anaerobic]] [[Streptococcus pyogenes|bacteria]] | * [[Streptococcus pyogenes|Aerobic and anaerobic]] [[Streptococcus pyogenes|bacteria]] | ||
* [[Streptococcus pyogenes|Streptococcus]][[Streptococcus pyogenes|pyogenes]] | * [[Streptococcus pyogenes|Streptococcus]][[Streptococcus pyogenes|pyogenes]] | ||
|On ultrasound [[Peritonsillar abscess|peritonsillar]] abscess appears as focal irregularly marginated hypoechoic area | |On ultrasound [[Peritonsillar abscess|peritonsillar]] abscess appears as focal irregularly marginated hypoechoic area | ||
| | | | ||
* [[Ampicillin-sulbactam|Ampicillin-sulbactam | * [[Ampicillin-sulbactam|Ampicillin-sulbactam]] | ||
* [[Clindamycin]] | * [[Clindamycin]] | ||
* [[Vancomycin]] | * [[Vancomycin]] | ||
* [[Linezolid]] | * [[Linezolid]] | ||
|- | |- | ||
|[[Croup]] | |[[Croup]]<ref name="Cherry2008">{{cite journal|last1=Cherry|first1=James D.|title=Croup|journal=New England Journal of Medicine|volume=358|issue=4|year=2008|pages=384–391|issn=0028-4793|doi=10.1056/NEJMcp072022}}</ref><ref name="Henrickson2003">{{cite journal|last1=Henrickson|first1=K. J.|title=Parainfluenza Viruses|journal=Clinical Microbiology Reviews|volume=16|issue=2|year=2003|pages=242–264|issn=0893-8512|doi=10.1128/CMR.16.2.242-264.2003}}</ref><ref name="SchomackerSchaap-Nutt2012">{{cite journal|last1=Schomacker|first1=Henrick|last2=Schaap-Nutt|first2=Anne|last3=Collins|first3=Peter L|last4=Schmidt|first4=Alexander C|title=Pathogenesis of acute respiratory illness caused by human parainfluenza viruses|journal=Current Opinion in Virology|volume=2|issue=3|year=2012|pages=294–299|issn=18796257|doi=10.1016/j.coviro.2012.02.001}}</ref> | ||
| | | | ||
* [[Cough]] | * [[Cough]] | ||
| Line 87: | Line 85: | ||
* ''[[Staphylococcus aureus]]'' | * ''[[Staphylococcus aureus]]'' | ||
* [[Fungi]] | * [[Fungi]] | ||
* [[Viruses]] | * [[Viruses]] | ||
|[[Thumbprint sign]] on neck x-ray | |[[Thumbprint sign]] on neck x-ray | ||
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| Line 94: | Line 92: | ||
* [[Adjuvant therapy]] includes: | * [[Adjuvant therapy]] includes: | ||
** [[corticosteroids]] | ** [[corticosteroids]] | ||
** [[racemic]] [[Epinephrine]] | ** [[racemic]] [[Epinephrine]] | ||
|- | |- | ||
|[[Pharyngitis]] | |[[Pharyngitis]]<ref name=":0">{{cite book | last = Ferri | first = Fred | title = Md consult/first consult 14-month subscription : combo retail pack | publisher = Elsevier Saunders | location = Place of publication not identified | year = 2005 | isbn = 9781416026075 }}</ref><ref name="pmid7989695">Kline JA, Runge JW (1994) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7989695 Streptococcal pharyngitis: a review of pathophysiology, diagnosis, and management.] ''J Emerg Med'' 12 (5):665-80. PMID: [https://pubmed.gov/7989695 7989695]</ref> | ||
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* [[Sore throat]] | * [[Sore throat]] | ||
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* [[Nausea]] and [[vomiting]] | * [[Nausea]] and [[vomiting]] | ||
| | | | ||
* [[Group A beta-hemolytic streptococci|Group A beta-hemolytic]] | * [[Group A beta-hemolytic streptococci|Group A beta-hemolytic]][[Group A beta-hemolytic streptococci|streptococcus]] | ||
[[Group A beta-hemolytic streptococci|streptococcus]] | |||
|_ | |_ | ||
| | | | ||
* [[Antimicrobial]] therapy mainly [[penicillin]]-based and [[analgesics]] | * [[Antimicrobial]] therapy mainly [[penicillin]]-based and [[analgesics]] | ||
|- | |- | ||
|[[Tonsilitis]] <ref name="pmid25946659">{{cite journal| author=Nogan S, Jandali D, Cipolla M, DeSilva B| title=The use of ultrasound imaging in evaluation of peritonsillar infections. | journal=Laryngoscope | year= 2015 | volume= 125 | issue= 11 | pages= 2604-7 | pmid=25946659 | doi=10.1002/lary.25313 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25946659 | |[[Tonsilitis]] <ref name="pmid25946659">{{cite journal| author=Nogan S, Jandali D, Cipolla M, DeSilva B| title=The use of ultrasound imaging in evaluation of peritonsillar infections. | journal=Laryngoscope | year= 2015 | volume= 125 | issue= 11 | pages= 2604-7 | pmid=25946659 | doi=10.1002/lary.25313 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25946659 }} </ref><ref name="pmid3601520">{{cite journal| author=Putto A| title=Febrile exudative tonsillitis: viral or streptococcal? | journal=Pediatrics | year= 1987 | volume= 80 | issue= 1 | pages= 6-12 | pmid=3601520 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3601520 }} </ref> | ||
| | | | ||
* [[Sore throat]] | * [[Sore throat]] | ||
| Line 128: | Line 126: | ||
* Bacterial | * Bacterial | ||
** ''[[Group A streptococcal infection|Group A streptococcal]][[Group A streptococcal infection|bacteria]]'' | ** ''[[Group A streptococcal infection|Group A streptococcal]][[Group A streptococcal infection|bacteria]]'' | ||
|Intraoral or transcutaneous USG may show an [[abscess]] making CT scan unnecessary | |Intraoral or transcutaneous USG may show an [[abscess]] making CT scan unnecessary | ||
| | | | ||
* | * [[Tonsillectomy]] | ||
* Antibiotic therapy | |||
|- | |- | ||
|Sinusitis<ref name="pmid12761699">{{cite journal| author=Vural C, Gungor A, Comerci S| title=Accuracy of computerized tomography in deep neck infections in the pediatric population. | journal=Am J Otolaryngol | year= 2003 | volume= 24 | issue= 3 | pages= 143-8 | pmid=12761699 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12761699 }} </ref><ref name="pmid15667676">{{cite journal| author=Philpott CM, Selvadurai D, Banerjee AR| title=Paediatric retropharyngeal abscess. | journal=J Laryngol Otol | year= 2004 | volume= 118 | issue= 12 | pages= 919-26 | pmid=15667676 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15667676 }} </ref> | |Sinusitis<ref name="pmid12761699">{{cite journal| author=Vural C, Gungor A, Comerci S| title=Accuracy of computerized tomography in deep neck infections in the pediatric population. | journal=Am J Otolaryngol | year= 2003 | volume= 24 | issue= 3 | pages= 143-8 | pmid=12761699 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12761699 }} </ref><ref name="pmid15667676">{{cite journal| author=Philpott CM, Selvadurai D, Banerjee AR| title=Paediatric retropharyngeal abscess. | journal=J Laryngol Otol | year= 2004 | volume= 118 | issue= 12 | pages= 919-26 | pmid=15667676 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15667676 }} </ref> | ||
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* Supportive therapy is the mainstay of treatment for both cases of [[acute]] and [[chronic]] rhinosinusitis | * Supportive therapy is the mainstay of treatment for both cases of [[acute]] and [[chronic]] rhinosinusitis | ||
* [[Antibiotics]]<nowiki/> | * [[Antibiotics]]<nowiki/> (macrolides, penicillins, clavulonic acid- amoxicillin) an be added in select cases of [[acute]], as well as [[chronic]] <nowiki/>rhinosinusitis | ||
|} | |} | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Otolaryngology]] | |||
[[Category:Pediatrics]] | |||
[[Category:Pulmonology]] | |||
[[Category:Emergency medicine]] | |||
[[Category:Infectious disease]] | |||
[[Category:Surgery]] | |||
Latest revision as of 20:17, 29 July 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]
Overview
Diagnosis of adenoiditis can be challenging as majority of upper respiratory tract infections show the same pattern. The most important differential diagnosis include tonsilitis, viral upper respiratory tract infection, sinusitis and pharyngitis.
Differential diagnosis
Adenoiditis must be differentiated from other diseases that cause fever, nasal airway obstruction and snoring, and sore throat.
The table below outlines the differences between adenoiditis and other respiratory tract infections.
Differential diagnosis based on fever and sore throat
| Disease/Variable | Presentation | Causes | Imaging finding | Treatment |
|---|---|---|---|---|
| Upper respiratory tract infection[1][2][3] |
|
|
_ | Symptomatic therapy: |
| Peritonsillar abscess[4][5] |
|
On ultrasound peritonsillar abscess appears as focal irregularly marginated hypoechoic area | ||
| Croup[6][7][8] | Steeple sign on neck X-ray |
| ||
| Epiglottitis[9][10] | Thumbprint sign on neck x-ray |
| ||
| Pharyngitis[11][12] |
|
_ |
| |
| Tonsilitis [13][14] |
|
|
Intraoral or transcutaneous USG may show an abscess making CT scan unnecessary |
|
| Sinusitis[15][16] | On CT scan, a mass impinging on the posterior pharyngeal wall with rim enhancement is seen |
|
References
- ↑ "Antibiotics for adults with acute laryngitis | Cochrane Summaries".
- ↑ http://www.cochrane.org/reviews/en/ab004403.html Antibiotics for exacerbations of chronic obstructive pulmonary disease
- ↑ http://www.cochrane.org/reviews/en/ab000980.html Vitamin C for preventing and treating the common cold
- ↑ Lyon M, Blaivas M (2005). "Intraoral ultrasound in the diagnosis and treatment of suspected peritonsillar abscess in the emergency department". Acad Emerg Med. 12 (1): 85–8. doi:10.1197/j.aem.2004.08.045. PMID 15635144.
- ↑ Boesen T, Jensen F (1992). "Preoperative ultrasonographic verification of peritonsillar abscesses in patients with severe tonsillitis". Eur Arch Otorhinolaryngol. 249 (3): 131–3. PMID 1642863.
- ↑ Cherry, James D. (2008). "Croup". New England Journal of Medicine. 358 (4): 384–391. doi:10.1056/NEJMcp072022. ISSN 0028-4793.
- ↑ Henrickson, K. J. (2003). "Parainfluenza Viruses". Clinical Microbiology Reviews. 16 (2): 242–264. doi:10.1128/CMR.16.2.242-264.2003. ISSN 0893-8512.
- ↑ Schomacker, Henrick; Schaap-Nutt, Anne; Collins, Peter L; Schmidt, Alexander C (2012). "Pathogenesis of acute respiratory illness caused by human parainfluenza viruses". Current Opinion in Virology. 2 (3): 294–299. doi:10.1016/j.coviro.2012.02.001. ISSN 1879-6257.
- ↑ Wick F, Ballmer PE, Haller A (2002). "Acute epiglottis in adults". Swiss Med Wkly. 132 (37–38): 541–7. PMID 12557859.
- ↑ Nickas BJ (2005). "A 60-year-old man with stridor, drooling, and "tripoding" following a nasal polypectomy". J Emerg Nurs. 31 (3): 234–5, quiz 321. doi:10.1016/j.jen.2004.10.015. PMID 15983574.
- ↑ Ferri, Fred (2005). Md consult/first consult 14-month subscription : combo retail pack. Place of publication not identified: Elsevier Saunders. ISBN 9781416026075.
- ↑ Kline JA, Runge JW (1994) Streptococcal pharyngitis: a review of pathophysiology, diagnosis, and management. J Emerg Med 12 (5):665-80. PMID: 7989695
- ↑ Nogan S, Jandali D, Cipolla M, DeSilva B (2015). "The use of ultrasound imaging in evaluation of peritonsillar infections". Laryngoscope. 125 (11): 2604–7. doi:10.1002/lary.25313. PMID 25946659.
- ↑ Putto A (1987). "Febrile exudative tonsillitis: viral or streptococcal?". Pediatrics. 80 (1): 6–12. PMID 3601520.
- ↑ Vural C, Gungor A, Comerci S (2003). "Accuracy of computerized tomography in deep neck infections in the pediatric population". Am J Otolaryngol. 24 (3): 143–8. PMID 12761699.
- ↑ Philpott CM, Selvadurai D, Banerjee AR (2004). "Paediatric retropharyngeal abscess". J Laryngol Otol. 118 (12): 919–26. PMID 15667676.