CONFIRMING DIAGNOSIS Indirect laryngoscopy confirms the diagnosis by revealing red, inflamed and, occasionally, hemorrhagic vocal cords, with rounded rather than sharp edges and exudate. Bilateral swelling may be present.
In severe cases or if toxicity is a concern, a culture of the exudate is obtained. Consider 24-hour pH probe testing in chronic laryngitis and gastroesophageal reflux disease (GERD). Also consider biopsy in chronic laryngitis in an adult with a history of smoking or alcohol abuse.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Acceleration-deceleration cervical injuries:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
Full cervical spine X-rays are required to rule out cervical fractures. If the X-rays are negative, the physical examination focuses on motor ability and sensation below the cervical spine to detect signs of nerve root compression.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Laryngeal cancer:
Diagnosis
(Handbook of Diseases)
Any hoarseness that lasts longer than 2 weeks requires visualization of the larynx by laryngoscopy.
A firm diagnosis also requires xeroradiography, a biopsy, laryngeal tomography, computed tomography scan, or laryngography to define the borders of the lesion, and a chest X-ray to detect metastasis.
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Source: Handbook of Diseases, 2003
Laryngitis:
Diagnosis
(Handbook of Diseases)
Indirect laryngoscopy confirms the diagnosis by revealing red, inflamed and, occasionally, hemorrhagic vocal cords, with rounded rather than sharp edges and exudate. Bilateral swelling may be present. In severe cases or if toxicity is a concern, a culture of the exudate is obtained.
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Source: Handbook of Diseases, 2003
Cervical Adenitis:
Diagnosis
(Pediatric Infectious Disease)
Diagnosis of Kawasaki syndrome is made by having five of the six clinical
criteria and by exclusion of other syndromes such as viral illnesses or
toxin-producing bacterial disease. Additional non-criteria signs of Kawasaki
disease, including sterile pyuria, marked elevation of the sedimentation rate,
and early growing desquamation, are frequently helpful in the diagnosis.
Thrombocytosis and palmar desquamation after the first 2 weeks of illness are
also characteristic.
A recent study suggested that the cervical lymph nodes in Kawasaki disease may
have specific ultrasonographic features; ultrasound appearance of the inflamed
nodes in Kawasaki syndrome is often a mass of multiple hypoechoic nodes
resembling a cluster of grapes. This is distinct from the ultrasound features
of routine bacterial lymphadenitis and can be helpful in patient evaluation.
The management of Kawasaki syndrome includes the use of intravenous immune
globulin (IVIG) at a dose of 2 mg/kg. High-dose aspirin, 80 to 100 mg/kg per
day in four divided doses, is used until the patient has resolution of fever.
The patient is then maintained on low-dose aspirin, 3 to 5 mg/kg per day for
about 6 weeks until platelet count and sedimentation rate become normal.
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Source: Pediatric Infectious Disease, 2004
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