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Tonsilītu diferenciāldiagnoze

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Tonsilītu diferenciāldiagnoze

  1. 1. Tonsilītu diferenciāldiagnoze Ilga Grīnberga MF IV 2011.
  2. 2. • http://upload.wikimedia.org/wikipedia/commons/thumb/4/4a/Pos_strep.JP x-Pos_strep.JPG• http://upload.wikimedia.org/wikipedia/commons/9/95/Tonsillitis.jpg• http://www.entusa.com/oral_photographs/20080801-acute-tonsillitis-745.j• http://farm4.static.flickr.com/3349/3592224706_87e8a2573a.jpg• http://www.sciencephoto.com/image/262975/530wm/M2700302-Tonsillitis• http://www.sciencephoto.com/image/262800/530wm/M2700103- Close_up_of_mouth_of_child_showing_tonsillitis-SPL.jpg• http://www.photographyblogger.net/wp-content/uploads/2009/05/coffee-
  3. 3. Infekcioza mononukleozeSynonyms: Pfeiffer’s glandular fever, kissing disease Infectious mononucleosis is caused by infection with the Epstein–Barr virus (EBV). It predominantly affects adolescents and young adults. The incubation period is 7–9 days. Clinical manifestations: Although infectious mononucleosis is a systemic illness, it is common to encounter tonsillitis as the initial or cardinal symptom. Besides systemic symptoms such as fatigue, anorexia, and moderate temperature elevation (38–390C), patients complain of severe pain on swallowing, headache, and limb pains.
  4. 4. http://www.health-reply.com/img/kg/infectious-mononucleosis-disease/infectious-mononucleosis.jpg
  5. 5. TBCOral or oropharyngeal manifestations of tuberculosis most commonly occur in the setting of advanced organ tuberculosis. Although these lesions are very rare (0.2% of patients with organ tuberculosis), they should be considered in the differential diagnosis since the incidence of tuberculosis has been on the rise. It is even less common to see oropharyngeal involvement by a primary complex or in the setting of miliary tuberculosis.Primary complex: A primary tuberculous complex in the tonsillar and cervical lymph-node region is most common in children who have become infected by drinking cow’s milk contaminated with tubercle bacilli. The primary complex in these cases consists of a typical ulcerative lesion of the oral mucosa and tonsil, associated with regional cervical lymphadenopathy. The swelling in the neck leads most patients to seekmedical attention.Miliary tuberculosis: Involvement of the oral mucosa can result from hematogenous spread, appearing as multiple pinhead-size papules, some hemorrhagic, that form on the oral mucosa.
  6. 6. DifterijaThe causative organism is Corynebacterium diphtheriae, which is transmitted by droplet inhalation or skin-to-skin contact. The incubation period is 1–5 days.The bacterium produces a special endotoxin that causes epithelial cell necrosis and ulcerations.Two main forms are distinguished based on their clinical presentation:• • Local, benign pharyngeal diphtheria• • Primary toxic, malignant diphtheria The disease begins with moderate fever and mild swallowing difficulties. The clinical picture becomes fully developed in approximately 24 hours, characterized by severe malaise, headache, and nausea.
  7. 7. http://www.virtualpediatrichospital.org/providers/ElectricAirway/PathImages/DiptheriaPseudo.jpg
  8. 8. ŠarlaksThe tonsillitis in scarlet fever is also caused by infection with group A β-hemolytic streptococci. These are highly virulent bacterial strains that produce the scarlet fever exotoxin.Clinically, patients present with a rash that begins on the trunk. The area around the mouth is spared (“perioral pallor”). A pathognomonic feature is a bright red tongue with a glistening surface and hyperplastic papillae (“raspberry tongue”). The tonsils are greatly swollen with a deep red color. Occasionally there is an enanthema of the soft palate with hemorrhagic areas.
  9. 9. http://www.ozzy.f2s.com/tonsils2.jpg
  10. 10. Plaut–Vincent Angina This inflammatory disease is caused by fusiform rods and spirochetes and presents clinically with unilateral dysphagia and a fetid breath odor with very little malaise.http://www.informed.hu/_Images/betegsegek/betegsegek_reszletesen/orl/pharynx_larynx_tonsilla/tonsillitis/000006091_20.jpg.jpg
  11. 11. HerpangīnaHerpangina is an acute febrile illness associated with small vesicular or ulcerative lesions on the posterior oropharyngeal structures (enanthem). Herpangina typically occurs during the summer and usually develops in children, occasionally occurring in newborns, adolescents, and young adultsHerpangina typically has an incubation period of 4-14 daysBilateral, anterior, cervical lymphadenopathy may occur, resulting from infection of the posterior oropharynx.
  12. 12. http://medicalpicturesinfo.com/wp-content/uploads/2011/09/Herpangina-Picture-2.jpg http://www.infektionsnetz.at/test/bilder/bildatlas/herpangina_r.jpg
  13. 13. Un vēl:GripaAkūts faringītsCitas ARVIMasalas – raksturīgi Filatova – Koplika plankumi, palielināta liesa un limfmezgli.
  14. 14. Izmantotā literatūra Basic otorhinolaryngology, R.Probst, G.Grevers, H.Ir o, 2006, p113-118 http://emedicine.medscape.com/article/2185 02-overviewhttp://y.delfi.lv/norm/65052/1680570_1RdyXU.jpeg
  15. 15. Paldies par uzmanību!http://fc01.deviantart.net/fs71/i/2010/270/3/a/cold_time_by_no_nox-d2zlj3q.jpg