DISEASES OF PHARYNX

DISEASES OF PHARYNX

Acute Pharyngitis

• Aetiology: Viral (most common), bacterial (Streptococcus pyogenes, Corynebacterium diphtheriae), and fungal infections
• Pathology: Inflammation of the pharyngeal mucosa, often with ulceration and edema
  • Step 1 → Viral or bacterial infection → Inflammation of pharyngeal mucosa → Ulceration and edema
• Clinical Features:
  • Sudden onset of sore throat
  • Pain on swallowing
  • Swollen and tender lymph nodes in the neck
  • Low-grade fever
  • White or yellowish patches on the tonsils
• Investigations:
  • Throat swab for bacterial culture and sensitivity
  • Rapid antigen detection test for Streptococcus pyogenes
• Management: Antibiotics for bacterial pharyngitis, analgesics and antipyretics for symptom relief

Chronic Pharyngitis

• Aetiology: Chronic irritation and inflammation of the pharyngeal mucosa, often due to allergies, gastroesophageal reflux disease (GERD), or chronic sinusitis
• Pathology: Chronic inflammation and scarring of the pharyngeal mucosa
  • Step 1 → Chronic irritation and inflammation → Scarring of pharyngeal mucosa
• Clinical Features:
  • Persistent sore throat
  • Difficulty swallowing
  • Hoarseness of voice
  • Chronic cough
  • Weight loss
• Investigations:
  • Endoscopy to visualize the pharynx and esophagus
  • Biopsy to rule out malignancy
• Management: Treatment of underlying cause, such as allergies or GERD, and symptom relief with medications and lifestyle modifications

Vincent’s Angina

• Definition: Acute necrotizing ulcerative gingivitis and pharyngitis
• Aetiology: Poor oral hygiene, stress, and smoking
• Clinical Features:
  • Severe pain and bleeding in the mouth
  • Ulceration and necrosis of the gingiva and pharyngeal mucosa
  • Swollen and tender lymph nodes in the neck
  • High fever
• Investigations:
  • Dental examination to rule out dental caries and gum disease
  • Throat swab for bacterial culture and sensitivity
• Management: Antibiotics, analgesics, and antipyretics, along with good oral hygiene and dental care

Diphtheritic Pharyngitis

• Definition: Infection of the pharynx by Corynebacterium diphtheriae
• Aetiology: Inadequate vaccination or exposure to an infected person
• Clinical Features:
  • Severe sore throat
  • Difficulty swallowing
  • Swollen and tender lymph nodes in the neck
  • Low-grade fever
  • Membranous covering on the tonsils
• Investigations:
  • Throat swab for bacterial culture and sensitivity
  • Rapid antigen detection test
• Management: Antibiotics, antitoxin, and supportive care, along with vaccination to prevent recurrence

Thrush

• Definition: Infection of the pharynx by Candida albicans
• Aetiology: Weakened immune system, diabetes, or prolonged use of antibiotics
• Clinical Features:
  • White patches on the tonsils and pharyngeal mucosa
  • Difficulty swallowing
  • Sore throat
  • Swollen and tender lymph nodes in the neck
• Investigations:
  • Throat swab for fungal culture and sensitivity
• Management: Antifungal medications, along with good oral hygiene and dietary modifications

Pharyngeal Abscess

• Definition: Collection of pus in the pharynx, often due to bacterial infection
• Aetiology: Poor oral hygiene, dental caries, or trauma
• Clinical Features:
  • Severe pain and difficulty swallowing
  • Swollen and tender lymph nodes in the neck
  • High fever
  • Trismus (lockjaw)
• Investigations:
  • Dental examination to rule out dental caries and gum disease
  • Throat swab for bacterial culture and sensitivity
• Management: Antibiotics, incision and drainage, and supportive care

Quinsy

• Definition: Peritonsillar abscess, a collection of pus behind the tonsils
• Aetiology: Poor oral hygiene, dental caries, or trauma
• Clinical Features:
  • Severe pain and difficulty swallowing
  • Swollen and tender lymph nodes in the neck
  • High fever
  • Trismus (lockjaw)
• Investigations:
  • Dental examination to rule out dental caries and gum disease
  • Throat swab for bacterial culture and sensitivity
• Management: Antibiotics, incision and drainage, and supportive care

Acute Retropharyngeal Abscess

• Definition: Collection of pus in the retropharyngeal space, often due to bacterial infection
• Aetiology: Trauma, dental caries, or poor oral hygiene
• Clinical Features:
  • Severe pain and difficulty swallowing
  • Swollen and tender lymph nodes in the neck
  • High fever
  • Trismus (lockjaw)
• Investigations:
  • Imaging studies (e.g., CT scan, MRI) to confirm the diagnosis
  • Throat swab for bacterial culture and sensitivity
• Management: Antibiotics, incision and drainage, and supportive care

Chronic Retropharyngeal Abscess

• Definition: Long-standing collection of pus in the retropharyngeal space
• Aetiology: Chronic infection or trauma
• Clinical Features:
  • Persistent pain and difficulty swallowing
  • Swollen and tender lymph nodes in the neck
  • High fever
  • Trismus (lockjaw)
• Investigations:
  • Imaging studies (e.g., CT scan, MRI) to confirm the diagnosis
  • Throat swab for bacterial culture and sensitivity
• Management: Antibiotics, incision and drainage, and supportive care

Parapharyngeal Abscess

• Definition: Collection of pus in the parapharyngeal space, often due to bacterial infection
• Aetiology: Trauma, dental caries, or poor oral hygiene
• Clinical Features:
  • Severe pain and difficulty swallowing
  • Swollen and tender lymph nodes in the neck
  • High fever
  • Trismus (lockjaw)
• Investigations:
  • Imaging studies (e.g., CT scan, MRI) to confirm the diagnosis
  • Throat swab for bacterial culture and sensitivity
• Management: Antibiotics, incision and drainage, and supportive care

Pharyngeal Diverticulum

• Definition: Herniation of the pharyngeal mucosa through a weakness in the pharyngeal wall
• Aetiology: Chronic inflammation, trauma, or poor swallowing mechanics
• Clinical Features:
  • Difficulty swallowing
  • Regurgitation of food
  • Chest pain
  • Weight loss
• Investigations:
  • Imaging studies (e.g., barium swallow, CT scan) to confirm the diagnosis
• Management: Speech therapy, dietary modifications, and in some cases, surgical intervention

Stylohyoid Syndrome

• Definition: Pain and stiffness in the neck and jaw due to inflammation of the stylohyoid ligament
• Aetiology: Poor posture, trauma, or overuse
• Clinical Features:
  • Pain and stiffness in the neck and jaw
  • Difficulty swallowing
  • Limited range of motion of the jaw
• Investigations:
  • Physical examination to confirm the diagnosis
• Management: Stretching exercises, physical therapy, and in some cases, surgery

Globus Hystericus

• Definition: Feeling of a lump or blockage in the throat, often associated with anxiety or stress
• Aetiology: Anxiety, stress, or psychological factors
• Clinical Features:
  • Feeling of a lump or blockage in the throat
  • Difficulty swallowing
  • Hoarseness of voice
  • Weight loss
• Investigations:
  • Psychological evaluation to confirm the diagnosis
• Management: Psychotherapy, relaxation techniques, and in some cases, medication

Pharyngeal Tumors

• Definition: Abnormal growths in the pharynx, often malignant
• Aetiology: Unknown, but may be associated with radiation exposure or smoking
• Clinical Features:
  • Difficulty swallowing
  • Weight loss
  • Hoarseness of voice
  • Pain in the neck or jaw
• Investigations:
  • Imaging studies (e.g., CT scan, MRI) to confirm the diagnosis
  • Biopsy to determine the type of tumor
• Management: Surgery, radiation therapy, and chemotherapy, depending on the type and stage of the tumor

Homoeopathic Treatment of Acute and Chronic Pharyngitis

• Medicines:
  • Aconitum napellus for sudden onset of symptoms
  • Belladonna for high fever and inflammation
  • Echinacea for immune system support
  • Lachesis for chronic inflammation and scarring
  • Phytolacca for chronic inflammation and pain
• Indications:
  • Sudden onset of symptoms: Aconitum napellus
  • High fever and inflammation: Belladonna
  • Immune system support: Echinacea
  • Chronic inflammation and scarring: Lachesis
  • Chronic inflammation and pain: Phytolacca

Homoeopathic Treatment of Pharyngeal Abscess

• Medicines:
  • Graphites for chronic inflammation and scarring
  • Hepar sulphuris for chronic inflammation and pain
  • Lachesis for chronic inflammation and scarring
  • Phytolacca for chronic inflammation and pain
• Indications:
  • Chronic inflammation and scarring: Graphites
  • Chronic inflammation and pain: Hepar sulphuris
  • Chronic inflammation and scarring: Lachesis
  • Chronic inflammation and pain: Phytolacca

Homoeopathic Treatment of Pharyngeal Tumors

• Medicines:
  • Antimonium crudum for malignant growths
  • Carbo vegetabilis for chronic inflammation and scarring
  • Lachesis for chronic inflammation and scarring
  • Phytolacca for chronic inflammation and pain
• Indications:
  • Malignant growths: Antimonium crudum
  • Chronic inflammation and scarring: Carbo vegetabilis
  • Chronic inflammation and scarring: Lachesis
  • Chronic inflammation and pain: Phytolacca