小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 声嘶
- 吞咽困难
- 咽痛
- 吞咽痛
- 咳嗽
- 口咽充血
- 用声过度病史
- 胃食管反流
- 口咽灰白色伪膜
其他诊断因素
- 鼻炎
- 乏力和不适感
- 发热
- 扁桃体肥大
- 颈前淋巴结肿大且有触痛
- 鼻后滴漏
- 呼吸困难
- 体重减轻
- 扁桃体咽部渗出
- 急性呼吸窘迫
- 呈中毒貌
- 流涎
- 喘鸣
危险因素
- 近期有上呼吸道感染病史
- 未完成B型流感嗜血杆菌（Hib）疫苗接种
- 未完成白喉疫苗接种
- 与感染患者接触
- 去白喉或结核流行地区旅游
- HIV或其他免疫抑制
- 养老院中的人群
- 皮质类固醇雾化或长期应用抗生素
- 用声过度
- 吸烟
诊断性检查
首要检查
- 喉镜检查
需考虑的检查
- 喉镜下取活检
- 口咽分泌物培养
- 鼻拭子培养
- 针对白喉行血清免疫沉淀、聚合酶链反应或免疫层析法检查
- 全血细胞计数
- 快速抗原检测
- 胸部 X 线检查
- 痰培养
- 结核菌素实验（PPD）
- 频闪喉镜检查
治疗流程
伴潜在气道损伤
病毒
疑似细菌性：非白喉和非结核性
确诊白喉
结核
真菌
发声困难
撰稿人
作者
Chad W. Whited, MD
Clinical Faculty
Laryngeal surgeon and general otolaryngologist
Austin ENT Clinic
Austin
Texas
利益声明
CWW declares that he has no competing interests.
Seth H. Dailey, MD
Chief
Section of Laryngology and Voice Surgery
Professor
Division of Otolaryngology - Head and Neck Surgery
University of Wisconsin School of Medicine and Public Health
Madison
WI
利益声明
SHD declares that he has no competing interests.
鸣谢
Dr Chad W. Whited and Dr Seth H. Dailey would like to gratefully acknowledge Dr Ozlem E. Tulunay-Ugur, a previous contributor to this topic. OETU declares that she has no competing interests.
同行评议者
Michael Johns, MD
Director
Assistant Professor
Emory University
Atlanta
GA
利益声明
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
利益声明
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
利益声明
RdB declares that he has no competing interests.
鉴别诊断
- 扁桃体炎
- 传染性单核细胞增多症
- 变应性鼻炎
更多 鉴别诊断指南
- 临床实践指南：嘶哑（发音障碍）
- 咽痛（急性）：抗微生物药物处方
更多 指南患者教育信息
咽痛
更多 患者教育信息
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