inflammations of pharynx

Inflammations of the Pharynx

1- Acute non-specific
2- Acute specific
3- Chronic non-specific
4- Chronic specific

Acute non-specific

Viral: more common
Secondary bacterial
Common in cold damp weather and in children
Clinical features: mild sore throat, mild constitutional symptoms( fever, malaise). Severe symptoms if there secondary bacterial infection.
On examination: diffuse mucosal congestion and enlarged tender cervical lymph nodes.
Complications: more prevalent in children
Otitis media,laryngitits,bronchitis,ludwigs angina,septicemia, acute rheumatism and nephritis.
Treatment: supportive

Acute specific

1- Herpetic: H.simplex and H.zoster
2- Vincents angina: fusifom bacilli and spirochetal Micro-organisms.
3- Diphtheric pharyngitis: Coryn.diphtheriae
4- Candidiasis: cand.albicans
5- Infectious mononucleosis
6- Blood dyscrasia


Herpetic pharyngitis
Simplex: caused by herpes simplex virus. Common condition which may be associated with herpes of the lips together with mild constitutional symptoms and small vesicles in the mouth and oropharynx.
Zoster: herpes zoster. Is a rare condition except in immunocompromised patients. Vesicles occur in the distribution of cranial nerves. Pain more severe.
Treatment: supportive and antivirals (acyclovir).

Chronic non-specific pharyngitis

Aetiology:
1- recurrent acute pharyngitis
2- sinusitis
3- dental
4- chemicals : alcohol,tobacco,dust
5- excessive or faulty use of voice.
Clinical features:
1- irritation
2- snoring
3- constant hawking (desire for clearing of the throat)
Treatment:
Correction of the underlying cause
No role for tonsillectomy op.


Chronic specific pharyngitis

1- TB pharyngitis

2- Syphilis
3- Others: leprosy, sarcoidosis, scleroma, wegners granulomatosis.

Oral manifestations of systemic disease

1- Hematological: agranulocytosis, leukemia, AIDS (hairy leukoplakia, candidiasis, kaposi’s sarcoma)
2- Acute exanthema: chicken pox, measles, glandular fever
3- Drug reactions: cytotoxic and sulpha (agranulocytosis) phenytoin (gum hyperplasia)
4- Vitamin deficiency: vit.c(gingivitis), iron, B-, 12 and folate deficincies(glossitis), nicotinic acid(cheilitis)
5- Autoimmune and connective tissue disease: SLE, rheumatoid arthritis, sjogrens synd., Behjet disease (oral ulcerations)

6- Cardiovascular: angina, cynosis, drugs

7- Cerebrovascular: CVA(motor and sensory dysfunction), anticoagulant(hge,petechial rash)
8- Pulmonary: COPD, steroids
9- Endocrine: DM(periodontal and bad oral health), addisons disease(pigmentation)
10- Gastro-intestinal: ulcerative colitis and crohns disease(oral ulceration)