Pharyngeal ulcer

Introduction Ulcer is a localized defect or ulceration of the skin or mucosal surface tissue. The surface is often covered with pus, necrotic tissue or ecdysis. The scar is left behind, which can be caused by infection, trauma, nodules or tumor rupture. Its size, shape, depth, development process, etc. are also inconsistent. Often combined with chronic infection, may not heal for a long time. There are many diseases that cause pharyngeal ulcers, and the reasons are different. In addition to some specific infections (diphtheria, tuberculosis, syphilis, induration, etc.) and pharyngeal tumors, the more common ulcer pseudomembranous lesions.

Cause

The cause of pharyngeal ulcer

Pharyngeal ulcers are most likely caused by long-term pharyngitis. Pharyngitis is a very common upper respiratory tract infection, often caused by colds and colds. Almost everyone has had the experience of the disease in their lifetime. Some people are sicker, some are heavier, some have People are easy to get, and some people don't often get it. The main symptoms of acute pharyngitis are acute onset, dry throat and burning at the beginning; followed by pain, sore throat is more obvious when swallowing saliva than with eating; may be accompanied by fever, headache, loss of appetite and limb pain; The throat can be accompanied by hoarseness and cough. The main symptoms of chronic pharyngitis are pharyngeal discomfort, dryness, itching, swelling, secretions and burning, easy to dry, foreign body sensation, and can not be swallowed. These symptoms are especially aggravated when you speak a little more, eat irritating food, fatigue or weather changes.

an examination

Related inspection

Ear, nose, throat swab bacterial culture Nasopharyngeal MRI examination Otolaryngology CT examination

Examination and diagnosis of pharyngeal ulcer

Pharyngeal ulcer is a limited defect and ulceration of the surface tissue of the pharynx mucosa. The surface is often covered with pus, necrotic tissue or ecdysis. After the scar, there is scar, which can be caused by infection, trauma, nodules or tumor rupture. As a result, its size, shape, depth, development process, etc. are also inconsistent. Often combined with chronic infection, with inflammation, may not heal for a long time.

Differential diagnosis

Ulcerative membranous lesion of pharyngeal ulcer

1, herpetic pharyngitis: caused by Coxsackie virus infection, more common in children under 7 years of age, acute onset, sudden high fever, 12 hours after onset, soft palate, uvula, tongue arch, tonsil, posterior pharynx On the wall, there are white herpes simplex with a diameter of about 1-2 mm. Herpes ruptures within 1-2 days, forming shallow ulcers, swelling of the submandibular lymph nodes, ulcers generally heal itself, no special treatment, local application of gold mold Sudaknin glycerol (chlortetracycline 0. 25G, dyclonine 0. 1G glycerol 10ML), analgesic and anti-inflammatory.

2, candida albicans: also known as thrush, caused by Candida albicans, common in infants and long-term sick patients with weak body, white curd in the soft palate, posterior pharyngeal wall and lips, tongue, cheek and other mucous membranes Plaque, plaque is easy to be scraped off, leaving a slight bleeding wound, but soon reborn, severe cases can be down to the throat, trachea, and esophagus. It can even invade the blood and become sepsis. The treatment should pay attention to the improvement of the general condition and strengthen the nutrition. The oral cavity and the pharynx can be cleaned with 4% sodium bicarbonate solution, and then coated with 1% gentian violet solution. The infected person is heavier. Nystatin is available.

3, Afotan stomatitis: is a common oropharyngeal mucosal disease, the cause is unknown, can be general and secretory disorders and central nervous system disorders, in the lips, tongue and cheeks and cleft lip and other places appear shallow shallow ulcers. There is a pseudomembrane formed by necrotic tissue at the bottom. Similar lesions can occur in soft palate, zygomatic arch or pharyngeal wall. The main symptom is pain. It is especially obvious when eating. The ulcer is expected to heal itself in about 10 days, but it often recurs. Treatment: coated with chlortetracycline dacron glycerin, has analgesic effect, using steroid hormones can promote healing, but can not prevent recurrence.

4, Fen Sen's angina: It is an ulcerative inflammation. The cause of the disease may be caused by a large number of anaerobic Clostridium and spirochetes in the oral cavity of normal people. It is generally not pathogenic and is poor in general condition. (such as prolonged bed rest, malnutrition) or neglected oral hygiene, tissue vitality decreased, can only occur, this disease often commits one side of the tonsils or gums, one side of sore throat, bad breath, dysphagia and other symptoms, cervical lymph nodes and There is tenderness, systemic symptoms have general discomfort, fever, etc., the upper end of the tonsil can be seen covered with gray-white pseudomembrane ulcer, the surrounding tissue is congested, the disease can be extended to the entire pharynx or oral cavity, the smear can find Fusobacterium and spirochetes That can confirm the diagnosis. The disease has a good prognosis and is effective with penicillin. The topical oxygenated solution (1-2% hydrogen peroxide solution, 1:3000 potassium permanganate solution) can be used for mouthwash.

5, mononucleosis angina: this disease is the pharyngeal manifestations of infectious mononucleosis. Epstein-Barr virus infection may be the cause of this disease. Patients are mostly adolescents with symptoms such as high fever, swollen lymph nodes, sore throat, and hepatosplenomegaly. The pharyngeal mucosa is diffusely congested, the upper ecchymosis, the adenoids, the tonsils are swollen, and sometimes ulcers and pseudomembranes can appear on the tonsils. Occasionally, the throat is edema, the symptoms of dyspnea appear, the white blood cell count is increased, among which lymphocytes account for more than 50%, and abnormal lymphocytes, positive for heterophilic agglutination test, are helpful for diagnosis, and the prognosis of this disease is good. Treatment: strengthen oropharyngeal cleansing care, use compound borax mouthwash to gargle, penicillin can control secondary infection, serotonin can be used for severe cases to reduce edema and infection.

6, granulocyte-deficient angina: for systemic diseases, due to some influence of the hematopoietic system, (drugs, radiation) inhibit the production of neutrophils, blood granulocytes significantly reduced, or even completely disappeared, the disease Often accompanied by pharyngeal ulcer disease, called granulocyte-deficient angina, the disease is more urgent, high fever, sore throat, difficulty swallowing, bad breath and other symptoms. The pharyngeal examination showed tonsil, and the mucosa of the zygomatic arch and soft palate was necrotic and ulcerated, and covered with a dark brown pseudomembrane. Oral mucosa and hernia have similar lesions. Due to the disappearance of granulocytes and secondary infections, the general condition has turned sharply and quickly, and it is rapidly depleted. Treatment: mainly in systemic treatment, promote granulocyte growth, while paying attention to supportive therapy and control of infection, pharynx and oral cavity can be rinsed with hydrogen peroxide solution or compound borax solution.

7, leukemia angina: is a blood cell disease of abnormal white blood cells, most patients often have pharyngeal lesions in the early stage, manifested as tonsil and pharyngeal ulcer necrosis, or leukemia angina. From the beginning of acute leukemia, there are often irregular fever. The main symptoms of pharyngeal lesions are tonsil enlargement. In severe cases, swallowing and respiratory disorders may occur. The pharyngeal mucosal edema is pale, and soft palate and zygomatic arch have ecchymosis or blemishes. Secondary infection, tonsil, soft palate, pharyngeal wall can appear necrosis and ulcers, covered with gray-white pseudomembrane, and bleeding tendency, ulcers can also occur in the oral mucosa and gums, acute leukemia often have systemic painless lymphadenopathy Blood tests, leukocytosis, and primordial and naive cells are more pronounced in bone marrow smears. Treatment: systemic chemotherapy, local use of mouthwash liquid, to keep mouth and throat clean, to prevent secondary infection.

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