Pharyngitis differential diagnosis: Difference between revisions
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|[[Hemolysis|H. influenza type b, beta-hemolytic]] [[streptococci]], ''[[Staphylococcus aureus]],'' [[fungi]] and [[viruses]]. | |[[Hemolysis|H. influenza type b, beta-hemolytic]] [[streptococci]], ''[[Staphylococcus aureus]],'' [[fungi]] and [[viruses]]. | ||
|Most common cause is viral including [[adenovirus]], [[rhinovirus]], [[influenza]], [[coronavirus]], and [[respiratory syncytial virus]]. Second most common causes are bacterial; ''[[Group A streptococcal infection|Group A streptococcal bacteria]]'',<sup>[[Epiglottitis differential diagnosis|[5]]]</sup> | |Most common cause is viral including [[adenovirus]], [[rhinovirus]], [[influenza]], [[coronavirus]], and [[respiratory syncytial virus]]. Second most common causes are bacterial; ''[[Group A streptococcal infection|Group A streptococcal bacteria]]'',<sup>[[Epiglottitis differential diagnosis|[5]]]</sup> | ||
|Polymicrobial infection. Mostly; [[Streptococcus pyogenes]], [[Staphylococcus aureus]] and respiratory anaerobes (e.g. [[Fusobacterium|Fusobacteria]], [[Prevotella species|Prevotella]], and Veillonella species)< | |Polymicrobial infection. Mostly; [[Streptococcus pyogenes]], [[Staphylococcus aureus]] and respiratory anaerobes (e.g. [[Fusobacterium|Fusobacteria]], [[Prevotella species|Prevotella]], and Veillonella species)<ref name="pmid23520072">{{cite journal| author=Cheng J, Elden L| title=Children with deep space neck infections: our experience with 178 children. | journal=Otolaryngol Head Neck Surg | year= 2013 | volume= 148 | issue= 6 | pages= 1037-42 | pmid=23520072 | doi=10.1177/0194599813482292 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23520072 }} </ref><ref name="pmid22481424">{{cite journal| author=Abdel-Haq N, Quezada M, Asmar BI| title=Retropharyngeal abscess in children: the rising incidence of methicillin-resistant Staphylococcus aureus. | journal=Pediatr Infect Dis J | year= 2012 | volume= 31 | issue= 7 | pages= 696-9 | pmid=22481424 | doi=10.1097/INF.0b013e318256fff0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22481424 }} </ref><ref name="pmid18948832">{{cite journal| author=Inman JC, Rowe M, Ghostine M, Fleck T| title=Pediatric neck abscesses: changing organisms and empiric therapies. | journal=Laryngoscope | year= 2008 | volume= 118 | issue= 12 | pages= 2111-4 | pmid=18948832 | doi=10.1097/MLG.0b013e318182a4fb | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18948832 }} </ref><ref name="pmid15573356">{{cite journal| author=Brook I| title=Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses. | journal=J Oral Maxillofac Surg | year= 2004 | volume= 62 | issue= 12 | pages= 1545-50 | pmid=15573356 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15573356 }} </ref><ref name="pmid18427007">{{cite journal| author=Wright CT, Stocks RM, Armstrong DL, Arnold SR, Gould HJ| title=Pediatric mediastinitis as a complication of methicillin-resistant Staphylococcus aureus retropharyngeal abscess. | journal=Arch Otolaryngol Head Neck Surg | year= 2008 | volume= 134 | issue= 4 | pages= 408-13 | pmid=18427007 | doi=10.1001/archotol.134.4.408 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18427007 }} </ref><ref name="pmid2235179">{{cite journal| author=Asmar BI| title=Bacteriology of retropharyngeal abscess in children. | journal=Pediatr Infect Dis J | year= 1990 | volume= 9 | issue= 8 | pages= 595-7 | pmid=2235179 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2235179 }} </ref> | ||
|- | |- | ||
|Physical exams findings | |Physical exams findings | ||
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|Diffuse lymphadenopathy, particularly bilateral and posterior cervical,[[Splenomegaly]] in 50% of cases, [[Hepatomegaly]] in 10% of cases, Pharyngeal petechiae, Rash in 90% of patients will develop a pruritic, [[maculopapular rash]] after the use of [[ampicillin]] or [[amoxicillin]] | |Diffuse lymphadenopathy, particularly bilateral and posterior cervical,[[Splenomegaly]] in 50% of cases, [[Hepatomegaly]] in 10% of cases, Pharyngeal petechiae, Rash in 90% of patients will develop a pruritic, [[maculopapular rash]] after the use of [[ampicillin]] or [[amoxicillin]] | ||
|[[Cyanosis]], [[Cervical]][[lymphadenopathy]], Inflammed [[epiglottis]] | |[[Cyanosis]], [[Cervical]][[lymphadenopathy]], Inflammed [[epiglottis]] | ||
|[[Fever]], especially 100°F or higher. | |[[Fever]], especially 100°F or higher.[[Erythema]], [[edema]] and [[Exudate]] of the [[tonsils]].cervical [[lymphadenopathy]], [[Dysphonia]].<ref name="Tonsillitis">Tonsillitis. Medline Plus. https://www.nlm.nih.gov/medlineplus/ency/article/001043.htm. Accessed May 2nd, 2016.</ref><ref name="urlTonsillitis - NHS Choices">{{cite web |url=http://www.nhs.uk/Conditions/Tonsillitis/Pages/Introduction.aspx |title=Tonsillitis - NHS Choices |format= |work= |accessdate=}}</ref><ref name="pmid25587367">{{cite journal |vauthors=Stelter K |title=Tonsillitis and sore throat in children |journal=GMS Curr Top Otorhinolaryngol Head Neck Surg |volume=13 |issue= |pages=Doc07 |year=2014 |pmid=25587367 |pmc=4273168 |doi=10.3205/cto000110 |url=}}</ref><ref name="urlTonsillitis - Symptoms - NHS Choices">{{cite web |url=http://www.nhs.uk/Conditions/Tonsillitis/Pages/Symptoms.aspx |title=Tonsillitis - Symptoms - NHS Choices |format= |work= |accessdate=}}</ref> | ||
|Child may be unable to open the mouth widely. May have enlarged | |Child may be unable to open the mouth widely. May have enlarged | ||
[[cervical]] [[lymph nodes]] and neck mass. | [[cervical]] [[lymph nodes]] and neck mass. | ||
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with 50% of cases identified | with 50% of cases identified | ||
between the ages of 5 to 24 years.< | between the ages of 5 to 24 years.<ref>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455748013 }}</ref> | ||
|Usually in [[immunocompromised]] patients, including those with advanced [[Human Immunodeficiency Virus (HIV)|HIV]]/AIDS | |Usually in [[immunocompromised]] patients, including those with advanced [[Human Immunodeficiency Virus (HIV)|HIV]]/AIDS | ||
|Common in adolescents between 15-25 | |Common in adolescents between 15-25 | ||
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however, recent trend favors adults | however, recent trend favors adults | ||
as most commonly affected individuals | as most commonly affected individuals with a mean age of 44.94 years.<ref name="pmid270310102">{{cite journal| author=Lichtor JL, Roche Rodriguez M, Aaronson NL, Spock T, Goodman TR, Baum ED| title=Epiglottitis: It Hasn't Gone Away. | journal=Anesthesiology | year= 2016 | volume= 124 | issue= 6 | pages= 1404-7 | pmid=27031010 | doi=10.1097/ALN.0000000000001125 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27031010 }}</ref> | ||
with a mean age of 44.94 years. | |||
|Primarily affects children | |Primarily affects children | ||
between 5 and 15 years old.< | between 5 and 15 years old.<ref name="Oroface">{{cite book |last1=Sharav |first1=Yair |last2=Benoliel |first2=Rafael |date=2008 |title=Orofacial Pain and Headache |url= |location= |publisher=Elsevier |page= |isbn=0723434123}}</ref> | ||
|Mostly between 2-4 years, but can occur in other age groups.< | |Mostly between 2-4 years, but can occur in other age groups.<ref name="pmid12777558">{{cite journal| author=Craig FW, Schunk JE| title=Retropharyngeal abscess in children: clinical presentation, utility of imaging, and current management. | journal=Pediatrics | year= 2003 | volume= 111 | issue= 6 Pt 1 | pages= 1394-8 | pmid=12777558 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12777558 }}</ref><ref name="pmid1876473">{{cite journal| author=Coulthard M, Isaacs D| title=Neonatal retropharyngeal abscess. | journal=Pediatr Infect Dis J | year= 1991 | volume= 10 | issue= 7 | pages= 547-9 | pmid=1876473 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1876473 }}</ref> | ||
|- | |- | ||
|Imaging finding | |Imaging finding | ||
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|— | |— | ||
|[[Thumbprint sign]] on neck x-ray | |[[Thumbprint sign]] on neck x-ray | ||
|Intraoral or transcutaneous USG may show an abscess making CT scan unnecessary.< | |Intraoral or transcutaneous USG may show an abscess making CT scan unnecessary.<ref name="pmid26527518">{{cite journal| author=Kawabata M, Umakoshi M, Makise T, Miyashita K, Harada M, Nagano H et al.| title=Clinical classification of peritonsillar abscess based on CT and indications for immediate abscess tonsillectomy. | journal=Auris Nasus Larynx | year= 2016 | volume= 43 | issue= 2 | pages= 182-6 | pmid=26527518 | doi=10.1016/j.anl.2015.09.014 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26527518 }} </ref><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="pmid25945805">{{cite journal| author=Fordham MT, Rock AN, Bandarkar A, Preciado D, Levy M, Cohen J et al.| title=Transcervical ultrasonography in the diagnosis of pediatric peritonsillar abscess. | journal=Laryngoscope | year= 2015 | volume= 125 | issue= 12 | pages= 2799-804 | pmid=25945805 | doi=10.1002/lary.25354 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25945805 }} </ref> | ||
|On CT scan, a mass impinging on the posterior pharyngeal wall with rim enhancement is seen< | |On CT scan, a mass impinging on the posterior pharyngeal wall with rim enhancement is seen.<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><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> | ||
|- | |- | ||
|Treatment | |Treatment | ||
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[[Glucocorticoids]] may be indicated in such cases of severe airway obstruction. | [[Glucocorticoids]] may be indicated in such cases of severe airway obstruction. | ||
|Airway maintenance, p[[Parenteral|arenteral]] [[Cefotaxime]] or [[Ceftriaxone]] in combination with [[Vancomycin]]. Adjuvant therapy includes [[corticosteroids]] and racemic [[Epinephrine]].< | |Airway maintenance, p[[Parenteral|arenteral]] [[Cefotaxime]] or [[Ceftriaxone]] in combination with [[Vancomycin]]. Adjuvant therapy includes [[corticosteroids]] and racemic [[Epinephrine]].<ref name="pmid15983574">{{cite journal| author=Nickas BJ| title=A 60-year-old man with stridor, drooling, and "tripoding" following a nasal polypectomy. | journal=J Emerg Nurs | year= 2005 | volume= 31 | issue= 3 | pages= 234-5; quiz 321 | pmid=15983574 | doi=10.1016/j.jen.2004.10.015 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15983574 }}</ref><ref name="pmid12557859">{{cite journal| author=Wick F, Ballmer PE, Haller A| title=Acute epiglottis in adults. | journal=Swiss Med Wkly | year= 2002 | volume= 132 | issue= 37-38 | pages= 541-7 | pmid=12557859 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12557859 }}</ref> | ||
|[[Antimicrobial]] therapy mainly [[penicillin]]-based and [[analgesics]] with [[tonsilectomy]] in selected cases. | |[[Antimicrobial]] therapy mainly [[penicillin]]-based and [[analgesics]] with [[tonsilectomy]] in selected cases. | ||
|Immediate surgical drainage and antimicrobial therapy. emperic therapy involves; [[Ampicillin-Sulbactam|ampicillin-sulbactam]] or [[clindamycin]]. | |Immediate surgical drainage and antimicrobial therapy. emperic therapy involves; [[Ampicillin-Sulbactam|ampicillin-sulbactam]] or [[clindamycin]]. | ||
Revision as of 23:03, 29 January 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]
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Pharyngitis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Pharyngitis differential diagnosis On the Web |
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American Roentgen Ray Society Images of Pharyngitis differential diagnosis |
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Risk calculators and risk factors for Pharyngitis differential diagnosis |
Overview
Pharyngitis should be differentiated from other infectious causes which mimic sore throat that includes oral thrush, infectious mononucleosis, epiglottitis and peritonsilar abscess.[1]
Differentiating Pharyngitis from other Diseases
The major goal of the differentiating patients with sore throat or acute pharyngitis is to exclude potentially dangerous causes (e.g. Group A streptococcus), to identify any treatable causes, and to improve symptoms. Identifying the treatable causes is important because timely treatment with antibiotics helps prevent complications such as acute rheumatic fever, post streptococcal glomerulonephritis.[2]
| Thrush | Mononucleosis | Epiglottitis | Peritonsillar abscess |
|---|---|---|---|
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| Variable | Pharyngitis | Oral thrush | Mononucleosis | Epiglottitis | Tonsilitis | Retropharyngeal abscess |
|---|---|---|---|---|---|---|
| Presentation |
|
Dysphagia without odynophagia which will differentiate it from pharyngitis. | Usually presents with a classic triad of
|
Usually present with stridor and drooling; and other symptoms include difficulty breathing, fever, chills, difficulty swallowing, hoarseness of voice | Sore throat, pain on swallowing, fever, headache, cough | Neck pain, stiff neck, torticollis |
| Causes | Group A beta-hemolytic streptococcus. | candidal infection | Epstein-Barr virus | H. influenza type b, beta-hemolytic streptococci, Staphylococcus aureus, fungi and viruses. | Most common cause is viral including adenovirus, rhinovirus, influenza, coronavirus, and respiratory syncytial virus. Second most common causes are bacterial; Group A streptococcal bacteria,[5] | Polymicrobial infection. Mostly; Streptococcus pyogenes, Staphylococcus aureus and respiratory anaerobes (e.g. Fusobacteria, Prevotella, and Veillonella species)[3][4][5][6][7][8] |
| Physical exams findings | Inflammed pharynx with or without exudate | White plaques that reveal an erythematous base when scraped | Diffuse lymphadenopathy, particularly bilateral and posterior cervical,Splenomegaly in 50% of cases, Hepatomegaly in 10% of cases, Pharyngeal petechiae, Rash in 90% of patients will develop a pruritic, maculopapular rash after the use of ampicillin or amoxicillin | Cyanosis, Cervicallymphadenopathy, Inflammed epiglottis | Fever, especially 100°F or higher.Erythema, edema and Exudate of the tonsils.cervical lymphadenopathy, Dysphonia.[9][10][11][12] | Child may be unable to open the mouth widely. May have enlarged
cervical lymph nodes and neck mass. |
| Age commonly affected | Mostly in children and young adults,
with 50% of cases identified between the ages of 5 to 24 years.[13] |
Usually in immunocompromised patients, including those with advanced HIV/AIDS | Common in adolescents between 15-25 | Used to be mostly found in
pediatric age group between 3 to 5 years, however, recent trend favors adults as most commonly affected individuals with a mean age of 44.94 years.[14] |
Primarily affects children
between 5 and 15 years old.[15] |
Mostly between 2-4 years, but can occur in other age groups.[16][17] |
| Imaging finding | — | — | — | Thumbprint sign on neck x-ray | Intraoral or transcutaneous USG may show an abscess making CT scan unnecessary.[18][19][20] | On CT scan, a mass impinging on the posterior pharyngeal wall with rim enhancement is seen.[21][22] |
| Treatment | Antimicrobial therapy mainly penicillin-based and analgesics. | oral fluconazole | Supportive therapy
Glucocorticoids may be indicated in such cases of severe airway obstruction. |
Airway maintenance, parenteral Cefotaxime or Ceftriaxone in combination with Vancomycin. Adjuvant therapy includes corticosteroids and racemic Epinephrine.[23][24] | Antimicrobial therapy mainly penicillin-based and analgesics with tonsilectomy in selected cases. | Immediate surgical drainage and antimicrobial therapy. emperic therapy involves; ampicillin-sulbactam or clindamycin. |
References
- ↑ Vincent MT, Celestin N, Hussain AN (2004) Pharyngitis. Am Fam Physician 69 (6):1465-70. PMID: 15053411
- ↑ Del Mar CB, Glasziou PP, Spinks AB (2006) Antibiotics for sore throat. Cochrane Database Syst Rev (4):CD000023. DOI:10.1002/14651858.CD000023.pub3 PMID: 17054126
- ↑ Cheng J, Elden L (2013). "Children with deep space neck infections: our experience with 178 children". Otolaryngol Head Neck Surg. 148 (6): 1037–42. doi:10.1177/0194599813482292. PMID 23520072.
- ↑ Abdel-Haq N, Quezada M, Asmar BI (2012). "Retropharyngeal abscess in children: the rising incidence of methicillin-resistant Staphylococcus aureus". Pediatr Infect Dis J. 31 (7): 696–9. doi:10.1097/INF.0b013e318256fff0. PMID 22481424.
- ↑ Inman JC, Rowe M, Ghostine M, Fleck T (2008). "Pediatric neck abscesses: changing organisms and empiric therapies". Laryngoscope. 118 (12): 2111–4. doi:10.1097/MLG.0b013e318182a4fb. PMID 18948832.
- ↑ Brook I (2004). "Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses". J Oral Maxillofac Surg. 62 (12): 1545–50. PMID 15573356.
- ↑ Wright CT, Stocks RM, Armstrong DL, Arnold SR, Gould HJ (2008). "Pediatric mediastinitis as a complication of methicillin-resistant Staphylococcus aureus retropharyngeal abscess". Arch Otolaryngol Head Neck Surg. 134 (4): 408–13. doi:10.1001/archotol.134.4.408. PMID 18427007.
- ↑ Asmar BI (1990). "Bacteriology of retropharyngeal abscess in children". Pediatr Infect Dis J. 9 (8): 595–7. PMID 2235179.
- ↑ Tonsillitis. Medline Plus. https://www.nlm.nih.gov/medlineplus/ency/article/001043.htm. Accessed May 2nd, 2016.
- ↑ "Tonsillitis - NHS Choices".
- ↑ Stelter K (2014). "Tonsillitis and sore throat in children". GMS Curr Top Otorhinolaryngol Head Neck Surg. 13: Doc07. doi:10.3205/cto000110. PMC 4273168. PMID 25587367.
- ↑ "Tonsillitis - Symptoms - NHS Choices".
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
- ↑ Lichtor JL, Roche Rodriguez M, Aaronson NL, Spock T, Goodman TR, Baum ED (2016). "Epiglottitis: It Hasn't Gone Away". Anesthesiology. 124 (6): 1404–7. doi:10.1097/ALN.0000000000001125. PMID 27031010.
- ↑ Sharav, Yair; Benoliel, Rafael (2008). Orofacial Pain and Headache. Elsevier. ISBN 0723434123.
- ↑ Craig FW, Schunk JE (2003). "Retropharyngeal abscess in children: clinical presentation, utility of imaging, and current management". Pediatrics. 111 (6 Pt 1): 1394–8. PMID 12777558.
- ↑ Coulthard M, Isaacs D (1991). "Neonatal retropharyngeal abscess". Pediatr Infect Dis J. 10 (7): 547–9. PMID 1876473.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Philpott CM, Selvadurai D, Banerjee AR (2004). "Paediatric retropharyngeal abscess". J Laryngol Otol. 118 (12): 919–26. PMID 15667676.
- ↑ 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.
- ↑ 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.
- ↑ Wick F, Ballmer PE, Haller A (2002). "Acute epiglottis in adults". Swiss Med Wkly. 132 (37–38): 541–7. PMID 12557859.