Fever sore throat: Difference between revisions

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===== The most important differential diagnosis for disease that cause fever and sorethroat at the same time are summarized in table below: =====
{{SK}} [[Fever and sore throat]]; [[sore throat fever]]; [[sore throat and fever]]; [[Sore throat fever]]
===== The most important differential diagnosis for disease that cause fever and sore throat at the same time are summarized in table below: =====
{| class="wikitable"
{| class="wikitable"
!Disease/Variable
!Disease/Variable
Line 111: Line 113:
between 5 and 15 years old.
between 5 and 15 years old.
|-
|-
|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>
|Diphtheria
|
|
* [[Nasal]] [[congestion]] and blockage
* Myocarditis
* [[Facial]] pain and pressure
* Sore throat
* [[Ear]] pressure or fullness
* Malaise
* [[Nasal discharge]], which may be [[purulent]]
* Cervical lymphadenopathy,
* Decreased or absent sense of [[smell]]
* Low-grade fever
* [[Headache]]
* Paryngitis with or without pseudomembrane
* [[Cough]]
* Systemic toxicity
* [[Fever]]
* Facial paralysis to total paralysis
* [[Fatigue]]
 
* Bad breath
 
* [[Maxillary]] tooth pain
|
|
* Viruses
* C. ''diphtheriae''
** [[Rhinovirus]]
* Rarely  ''Corynebacterium'' species
** [[Influenza virus]]
 
** [[Parainfluenza virus]]


* Bacteria
|X-ray:
** [[Streptococcus pneumoniae]]
* Diphtheric [[myocarditis]]: Cardiomegaly in CXR
** [[Haemophilus influenzae]]
* [[Bronchopneumonia]]
** [[Moraxella catarrhalis]]
|[[Diphtheria]] [[antitoxin]]
** [[Streptococcus pyogenes]]
Antibiotics may help in disease prevention
** [[Staphylococcus aureus]]: common in chronic [[sinusitis]]
** [[Pseudomonas aeruginosa]]
|On CT scan, a mass impinging on the posterior [[pharyngeal]] wall with rim enhancement is seen
|Supportive therapy is the mainstay of treatment for both cases of [[acute]] and [[chronic]] rhinosinusitis. [[Antibiotics]]<nowiki/>c(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}}

Latest revision as of 15:32, 26 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

Synonyms and keywords: Fever and sore throat; sore throat fever; sore throat and fever; Sore throat fever

The most important differential diagnosis for disease that cause fever and sore throat at the same time are summarized in table below:
Disease/Variable Presentation Causes Imaging finding Treatment
Upper respiratory tract infection _ Symptomatic therapy:
Peritonsillar abscess[1][2][3][4][5][2][3][6][7][8][9] On ultrasound peritonsillar abscess appears as focal irregularly marginated hypoechoic area. Ampicillin-sulbactam, Clindamycin, Vancomycin or Linezolid
Croup Steeple sign on neck X-ray Dexamethasone and nebulised epinephrine
Epiglottitis[10][11] Thumbprint sign on neck x-ray Airway maintenance, parenteral Cefotaxime or Ceftriaxone in combination with Vancomycin. Adjuvant therapy includes corticosteroids and racemic Epinephrine.
Pharyngitis

streptococcus

_ Antimicrobial therapy mainly penicillin-based and analgesics.
Tonsilitis [12][13][14][15] Intraoral or transcutaneous USG may show an abscess making CT scan unnecessary. Primarily affects children

between 5 and 15 years old.

Diphtheria
  • Myocarditis
  • Sore throat
  • Malaise
  • Cervical lymphadenopathy,
  • Low-grade fever
  • Paryngitis with or without pseudomembrane
  • Systemic toxicity
  • Facial paralysis to total paralysis


  • C. diphtheriae
  • Rarely  Corynebacterium species


X-ray: Diphtheria antitoxin

Antibiotics may help in disease prevention

References

  1. Galioto NJ (2008). "Peritonsillar abscess". Am Fam Physician. 77 (2): 199–202. PMID 18246890.
  2. 2.0 2.1 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.
  3. 3.0 3.1 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.
  4. Bandarkar AN, Adeyiga AO, Fordham MT, Preciado D, Reilly BK (2016). "Tonsil ultrasound: technical approach and spectrum of pediatric peritonsillar infections". Pediatr Radiol. 46 (7): 1059–67. doi:10.1007/s00247-015-3505-7. PMID 26637999.
  5. Scott PM, Loftus WK, Kew J, Ahuja A, Yue V, van Hasselt CA (1999). "Diagnosis of peritonsillar infections: a prospective study of ultrasound, computerized tomography and clinical diagnosis". J Laryngol Otol. 113 (3): 229–32. PMID 10435129.
  6. Brook I (2004). "Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses". J Oral Maxillofac Surg. 62 (12): 1545–50. PMID 15573356.
  7. Megalamani SB, Suria G, Manickam U, Balasubramanian D, Jothimahalingam S (2008). "Changing trends in bacteriology of peritonsillar abscess". J Laryngol Otol. 122 (9): 928–30. doi:10.1017/S0022215107001144. PMID 18039418.
  8. Snow DG, Campbell JB, Morgan DW (1991). "The microbiology of peritonsillar sepsis". J Laryngol Otol. 105 (7): 553–5. PMID 1875138.
  9. Matsuda A, Tanaka H, Kanaya T, Kamata K, Hasegawa M (2002). "Peritonsillar abscess: a study of 724 cases in Japan". Ear Nose Throat J. 81 (6): 384–9. PMID 12092281.
  10. Wick F, Ballmer PE, Haller A (2002). "Acute epiglottis in adults". Swiss Med Wkly. 132 (37–38): 541–7. PMID 12557859.
  11. 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.
  12. 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.
  13. Kawabata M, Umakoshi M, Makise T, Miyashita K, Harada M, Nagano H; et al. (2016). "Clinical classification of peritonsillar abscess based on CT and indications for immediate abscess tonsillectomy". Auris Nasus Larynx. 43 (2): 182–6. doi:10.1016/j.anl.2015.09.014. PMID 26527518.
  14. Fordham MT, Rock AN, Bandarkar A, Preciado D, Levy M, Cohen J; et al. (2015). "Transcervical ultrasonography in the diagnosis of pediatric peritonsillar abscess". Laryngoscope. 125 (12): 2799–804. doi:10.1002/lary.25354. PMID 25945805.
  15. Putto A (1987). "Febrile exudative tonsillitis: viral or streptococcal?". Pediatrics. 80 (1): 6–12. PMID 3601520.