Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • hoarseness
  • dysphagia
  • sore throat
  • odynophagia
  • cough
  • hyperaemia of the oropharynx
  • oropharyngeal white-grey exudates
  • hx of heavy vocal use
  • gastro-oesophageal reflux

Other diagnostic factors

  • rhinitis
  • fatigue and malaise
  • fever
  • enlarged tonsils
  • enlarged, tender anterior cervical lymph nodes
  • post-nasal drip
  • dyspnoea
  • weight loss
  • tonsillopharyngeal exudate
  • acute respiratory distress
  • toxic appearance
  • drooling
  • stridor

Risk factors

  • recent hx of URI
  • incomplete or absent Haemophilus influenzae type B (Hib) vaccination
  • incomplete or absent diphtheria vaccination
  • contact with infected individual
  • travel to area where diphtheria or tuberculosis are endemic
  • HIV or other immunocompromise
  • residence in a nursing home
  • inhaled corticosteroids or prolonged courses of antibiotics
  • heavy vocal use
  • tobacco use

Diagnostic investigations

Investigations to consider

  • biopsy during laryngoscopy
  • oropharyngeal cultures
  • nasal swab for culture
  • serum immunoprecipitation, PCR, or immunochromatography for diphtheria
  • FBC
  • rapid antigen detection test
  • CXR
  • sputum cultures
  • purified protein derivative skin test (PPD)
  • videostroboscopy
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Clinical Faculty

Laryngeal surgeon and general otolaryngologist

Austin ENT Clinic

Austin

Texas

Disclosures

CWW declares that he has no competing interests.

Chief

Section of Laryngology and Voice Surgery

Associate Professor

Division of Otolaryngology - Head and Neck Surgery

University of Wisconsin School of Medicine and Public Health

Madison

WI

Disclosures

SHD declares that he has no competing interests.

Dr Chad W. Whited and Dr Seth H. Dailey would like to gratefully acknowledge Dr Ozlem E. Tulunay-Ugur, a previous contributor to this monograph. OETU declares that she has no competing interests.

Peer reviewers VIEW ALL

Director

Assistant Professor

Emory University

Atlanta

GA

Disclosures

MJ declares that he has no competing interests.

Chair; Professor

University of Arkansas for Medical Sciences

Department of Otolaryngology - Head and Neck Surgery

Little Rock

AR

Disclosures

JS declares that he has no competing interests.

Otolaryngologist

Head and Neck Surgeon

VU University Medical Center

Amsterdam

The Netherlands

Disclosures

RdB declares that he has no competing interests.

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