Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- rouquidão
- disfagia
- faringite
- odinofagia
- tosse
- hiperemia da orofaringe
- história de uso vocal intenso
- refluxo gastroesofágico
- exsudatos branco-acinzentados orofaríngeos
Other diagnostic factors
- rinite
- fadiga e mal-estar
- febre
- amígdalas aumentadas
- linfonodos cervicais anteriores aumentados e sensíveis
- gotejamento pós-nasal
- dispneia
- perda de peso
- exsudato tonsilofaríngeo
- desconforto respiratório agudo
- aparência toxêmica
- sialorreia
- estridor
Risk factors
- história recente de infecção respiratória superior
- vacinação incompleta ou ausente contra a Haemophilus influenzae do tipo B (Hib)
- vacinação incompleta ou ausente contra a difteria
- contato com pessoa infectada
- viagens para locais onde a difteria ou a tuberculose são endêmicas
- vírus da imunodeficiência humana (HIV) ou outro imunocomprometimento
- uso de corticosteroides inalatórios ou ciclos prolongados de antibióticos
- uso vocal intenso
- tabagismo
Diagnostic tests
1st tests to order
- laringoscopia
Tests to consider
- biópsia
- culturas orofaríngeas
- swab nasal para cultura
- imunoprecipitação sérica ou reação em cadeia da polimerase para difteria
- hemograma completo
- teste rápido de detecção de antígeno
- radiografia torácica
- culturas de escarro
- videoestroboscopia
Treatment algorithm
com possível comprometimento das vias aéreas
viral
suspeita bacteriana: não diftérica e não tuberculosa
difteria confirmada
tuberculose
fúngica
tensão vocal
Contributors
Authors
Vaninder Kaur Dhillon, MD
Assistant Professor
Johns Hopkins University
Otolaryngology-Head and Neck Surgery
Divisions of Laryngology and Endocrine Head and Neck Surgery
Bethesda
MD
Disclosures
VKD declares that she has no competing interests.
Acknowledgements
Dr Vaninder Kaur Dhillon would like to gratefully acknowledge Dr Chad W. Whited, Dr Seth H. Dailey and Dr Ozlem E. Tulunay-Ugur, the previous contributors to this topic. CWW, SHD and OETU declare that they have no competing interests.
Peer reviewers
Michael Johns, MD
Director
Assistant Professor
Emory University
Atlanta
GA
Disclosures
MJ declares that he has no competing interests.
James Suen, MD
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.
Remco de Bree, MD, PhD
Otolaryngologist
Head and Neck Surgeon
VU University Medical Center
Amsterdam
The Netherlands
Disclosures
RdB declares that he has no competing interests.
References
Key articles
House S A, Fisher E L. Hoarseness in adults. Am Fam Physician. 2017 Dec 1;96(11):720-8.Full text
Dworkin JP. Laryngitis: types, causes, and treatments. Otolaryngol Clin North Am. 2008 Apr;41(2):419-36. Abstract
Stachler RJ, Francis DO, Schwartz SR, et al. Clinical practice guideline: hoarseness (dysphonia) (update). Otolaryngol Head Neck Surg. 2018 Mar;158(1_suppl):S1-S42.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Amigdalite
- Mononucleose infecciosa
- Rinite alérgica
More DifferentialsGuidelines
- Clinical practice guideline: hoarseness (dysphonia)
- Sore throat (acute): antimicrobial prescribing
More GuidelinesPatient information
Faringite
More Patient information
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