Download - 3 Chronic Pharyngitis 28-10-2007
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Chronic pharyngitis
Non specific
1- Chronic simple pharyngitis
Specific
1- Scleroma
2- Syphilis
3- Tuberculosis
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Chronic simple pharyngitisEtiology :1-Recurrent acute pharyngitis
2- Mouth breathing
3- Smoking & spirits
4- GERD
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Symptoms :
- History of repeated attacks of sore throat- Throat irritation (hemming نحنحه&hawking تنخيم)
Signs:
- Catarrhal, mild hyperaemia of the pharyngeal mucosa
- Hypertrophic, scattered nodules on the posterior pharyngeal wall
Treatment: of the cause
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• This middle aged female presented with gradually progressive dysphagia
1- the patient is most probably suffering from………….2- you should proceed to the following investigations:A- B-
koilonychia Atrophic GlossitisAngular Stomatitis
AnswerThis middle aged female presented with gradually progressive dysphagia 1- the patient is most probably suffering from PLUMMER VINSON SYNDROME.2- you should proceed to the following investigations:A- Blood Picture (Hypochromic Anemia)B- gastric secretion (achlorohydriaC- Barium Swallow (web)
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• Plummer-Vinson or Paterson-Kelly syndrome presents as a classical triad of dysphagia, iron-deficiency anemia and
esophageal webs
Age: Middle age
Sex: 90% in females Etiology: Un-clear, may be
- iron deficiency anemia- Vitamin deficiency- or autoimmune processes
Pathology: Atrophy of :Pharyngeal
Esophageal &
Gastric mucosa
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Symptoms
GeneralPharyngeal
Weakness, fatigue, and dyspneaare Secondary to iron deficiencyanemia
SignsGeneral
Pharyngeal
Dysphagia, if present, is typically
intermittent and limited to solids.
It is usually felt in the throat
Angular stomatitis
Glossitis
Atrophic glazed mucosa of the
hypopharynx
Koilonychia
Spleenomegaly
Pallor
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Investigations
Complications
Treatment
- Stricture at the cicopharyngeal
Sphincter
- Pre-cancerous: postcricoid
carcinoma &esophageal carcinoma
Blood picture: hypochromic anemia
Gastric secretion: achlorohydi due to atrophy of gastric mucosa
Barium swallow
HypopharyngoscopyIron & vitamine supply
Repeated endoscopic dilatation
Regular follow up for early detection of
postcricoid carcinoma &esophageal
carcinoma
Web
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Chronic Specific • Scleroma • Tuberculosis• Syphilis
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PharyngoscleromaSee Rhinoscleroma for more details
Clinically
• Atrophic
• Nodular
• Fibrotic
Dry glazed mucosa
Pink indurated non ulcerating , painless nodules
Shortened uvulaPharyngeal Stenosis
Etilogy:Secondary to Rhinoscleroma
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Tuberculous pharyngitis
Clinically• Pallor of the mucosa • Typical ulcers
PainfulSuperficialShallowUndermined edgeCaseous floor
Etilogy:Secondary to Pulmonary
Tuberculosis
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Syphilitic pharyngitis
Secondary : -Hyperaemic mucosa-Mucous patches-Snail track ulcers
Primary :Chancre, rare in the pharynx
Tertiary: GummaPinkish rubbery swellings
--►typical ulcer
Single painless indurated papule
Deep punched out edgeNecrotic dirty yellow floor