Throat Conditions

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TONSILLITIS

Acute inflammation of the tonsils. The main organism implicated in the causation is betahemolytic streptococcal.

Clinical Features

SYMPTOMS AND SIGNS:

  • Sore throat, difficulty and pain on swallowing, inflamed tonsils, multiple white spots on the tonsillar surface, and sudden onset of fever.

INVESTIGATIONS

  • FBC
  • Throat swab for culture and sensitivity

Treatment

NON-PHARMACOLOGICAL

  • Warm salt gargles

PHARMACOLOGICAL

  • Give Amoxicillin 500mg 8 hourly for 7 days
  • In severe infection, Amoxicillin 250/500mg + Clavulanic acid 125mg 8 hourly for 5-7 days

Alternatively:

  • Give Erythromycin 500mg, every 8 hours in Penicillin allergy
  • Give Analgesia see Section 24.1 in Malawi STG on pain relief

Refer if

  • Peritonsillar abscess
  • If symptoms persist or recurring episodes of 4-5 attacks per year

 

AIRWAY EMERGENCIES

Foreign Body Inhalation

Clinical Features

SYMPTOMS AND SIGNS:

  • Sudden onset of cough and choking is the frequent initial symptom. Signs of upper airway obstruction such as difficulties in breathing, stridor, use of accessory muscles to breathe. 

Treatment

PHARMACOLOGICAL

  • Give oxygen
  • Refer for Bronchoscopy

LARYNGOPHARYNGEAL REFLUXLPR is the retrograde (backward) movement of stomach enzymes (Pepsin) and acid into the lower throat region.

Clinical Features

SIGNS AND SYMPTOMS

  • Excessive throat-clearing
  • Persistent dry cough
  • Sore throats not associated with a cold
  • Hoarseness, or globes pharynges (feeling of a lump in the throat).

Treatment

NON-PHARMACOLOGICAL

  • Dietary modification
    • Avoid Caffeine, alcohol, chocolates, and peppermints, Citrus fruits, pineapples, tomatoes (and other acidic foods), and hot spices
  • Lifestyle changes
    • Smaller and more frequent feedings
    • Stop eating at least three hours before going to bed
    • Avoid wearing tight fitting clothes
    • Lose weight if needed

PHARMACOLOGICAL

  • Proton Pump Inhibitors (PPIs) are the most effective medicines for the treatment of LPR. PPIs must be taken on an empty stomach, ½ hour before a meal.