1/12. Supraesophageal manifestations of gastroesophageal reflux disease.An increasing amount of evidence indicates that gastroesophageal reflux disease (GERD) is a contributing factor to hoarseness, throat clearing, throat discomfort, chronic cough, and shortness of breath. The association between GERD and these supraesophageal symptoms may be elusive. heartburn and regurgitation are absent in more than 50% of patients. Acid reflux should be considered if signs of GERD are present, symptoms are unexplained, or symptoms are refractory to therapy. The diagnosis of GERD may be unclear, despite a careful history and initial evaluation. A high index of suspicion is required to make the diagnosis. An empiric trial of antireflux therapy is appropriate when GERD is suspected. Multiprobe ambulatory pH monitoring is currently the diagnostic test of choice, but the level of sensitivity and specificity for supraesophageal manifestations of GERD is uncertain. Response to antireflux therapy is less predictable than typical GERD. More intensive acid suppression and longer treatment duration are usually required.- - - - - - - - - - ranking = 1keywords = throat (Clic here for more details about this article) |
2/12. Persistent cough in an adolescent.Jessica, a 14-year-old girl with a history of asthma, went to her pediatrician's office because of a persistent cough. She had been coughing for at least 3 months with occasional cough-free periods of less than a few days. The cough was nonproductive and was not accompanied by fever, rhinorrhea, or facial or chest pain. Jessica and her mother observed that the cough increased with exercise and typically was not present during sleep. She has used two metered-dose inhalers--albuterol and cromolyn--without any change in the cough pattern. For the past 5 years, Jessica has had mild asthma responsive to albuterol. She enjoys running on the cross-country team, soccer, and dancing. She is an average student and denies any change in academic performance. She has never been hospitalized or had an emergency department visit for asthma or pneumonia. There has been no recent travel or exposure to a person with a chronic productive cough, tobacco smoke, or a live-in pet. Jessica lives with her mother and younger sister in a 10-year-old, carpeted apartment without any evidence of mold or recent renovation. In the process of taking the history, the pediatrician noticed that Jessica coughed intermittently, with two or three coughs during each episode. At times, the cough was harsh; at other times, it was a quiet cough, as if she were clearing her throat. She was cooperative, without overt anxiety or respiratory distress. After a complete physical examination with normal findings, the pediatrician interviewed Jessica and her mother alone. Jessica's parents had been divorced for the past 6 years. She lived with her mother but visited her father, and his new family with two young children, every weekend. She spoke about this arrangement comfortably and said that she loved her father and mother but didn't like the tension she experienced at her father's home. "I don't like adults arguing when kids are around." When asked why she thought the cough persisted so long, she commented in a neutral tone, "I don't know. It's never been like this before." Jessica's pediatrician prescribed an inhaled steroid with the albuterol. When the cough did not respond after 1 week, he ordered a chest radiograph (normal) and a tuberculin skin test (purified protein derivative-negative), and he added montelukast (a leukotriene inhibitor) and monitored airway resistance with a peak flow meter. The cough persisted, and the peak flow recording showed normal airway resistance. At this time, Jessica's pediatrician suspected a conversion reaction and contemplated the next best therapeutic strategy.- - - - - - - - - - ranking = 0.5keywords = throat (Clic here for more details about this article) |
3/12. Lemierre's syndrome. sepsis complicating an anaerobic oropharyngeal infection.Previously healthy people without interfering conditions are rarely affected by anaerobic infections. We report a young patient with extended septic emboli in the lungs, after an episode of sore throat, due to anaerobic bacteremia with fusobacterium necrophorum. The first description of oropharyngeal infection complicated by sepsis was given by Lemierre in 1936. knowledge of Lemierre's syndrome should lead to early recognition and prompt action against this sporadic and possible fatal illness.- - - - - - - - - - ranking = 4.7385435291438keywords = sore throat, throat (Clic here for more details about this article) |
4/12. Psychogenic cough in adults: a report of two cases and review of the literature.Psychogenic cough, also known as "habit cough," is a well-documented condition in the pediatric and adolescent population, with numerous cases reported in the medical literature. Many of these patients are strikingly similar in their clinical characteristics and, although the data are limited, a variety of treatment options may be successful in terminating this form of cough. However, psychogenic cough in adults has been reported infrequently and is less well defined. We report two cases of psychogenic cough in adult patients referred to our service for an evaluation of refractory, chronic cough and review the relevant medical literature. Our patients seemingly represent the first cases of psychogenic cough reported in the geriatric population and share clinical features with children, adolescents, and young adults. One case is unique in the sense that the cough responded to a distracter in the form of a throat lozenge, and this patient consumed > or = 20 lozenges/day for approximately 13 years. Psychogenic cough should be considered in adult patients who present with a chronic cough of no obvious organic basis that has failed therapy directed at postnasal drip, asthma, and gastroesophageal reflux. We propose criteria to assist in making a diagnosis of psychogenic cough in adult patients and review the limited information that exists concerning treatment modalities.- - - - - - - - - - ranking = 0.5keywords = throat (Clic here for more details about this article) |
5/12. Unusual cause of chronic cough in a four-year-old cured by uvulectomy.A 4-year-old boy had a history of persistent barking cough unresponsive to medical treatment since infancy. He described a feeling of something in his throat. When investigated by flexible fiberoptic bronchoscopy, the only abnormality was the uvula resting in contact with the epiglottis. The cough was no longer present after uvulectomy.- - - - - - - - - - ranking = 0.5keywords = throat (Clic here for more details about this article) |
6/12. fatigue, sore throat, and cough in a 24-year-old active duty man.A 24-year-old active duty male smoker presented with 3 days of fatigue, rhinorrhea, and sore throat. The diagnosis and management of pharyngitis, including a field friendly approach, are reviewed. The impact of the discontinuation of the adenovirus vaccine to military recruits is highlighted. The effects of smoking among military personnel are discussed, and smoking cessation measures are reviewed.- - - - - - - - - - ranking = 23.692717645719keywords = sore throat, throat (Clic here for more details about this article) |
7/12. Severe anemia following uvulectomy in kenya.Uvulectomy is a common practice in eastern africa for treatment of a variety of throat conditions. Traditional healers perform the procedure. I present a case report to illustrate a complication of uvulectomy. This is a report of a child who presented with severe anemia secondary to uvulectomy performed for treatment of chronic cough. This case report is intended to illustrate a procedure not commonly performed by western otolaryngologists and to describe the management of a severe complication. Western physicians are increasingly being tasked in medical situations in which they encounter traditional medical practices outside of their scope of training. The intent of this report is to familiarize western physicians with one such procedure and its potential complications.- - - - - - - - - - ranking = 0.5keywords = throat (Clic here for more details about this article) |
8/12. Respiratory tract symptoms as a clue to giant cell arteritis.Although many manifestations of giant cell arteries are increasingly recognized, little attention has been paid to respiratory symptoms associated with this disorder. We report the cases of 16 patients with giant cell arteritis who had prominent symptoms related to the respiratory tract including cough, sore throat, and hoarseness. These symptoms were the initial finding in 10 patients and obscured the diagnosis in some instances, but resolved quickly when corticosteroids were given. It is estimated that 9% of patients with giant cell arteritis have prominent respiratory tract symptoms, which are the initial manifestation in 4%. This disorder should be considered in an older patient with a new cough or throat pain without obvious cause.- - - - - - - - - - ranking = 5.2385435291438keywords = sore throat, throat (Clic here for more details about this article) |
9/12. Contact ulcers and granulomas of the larynx: new insights into their etiology as a basis for more rational treatment.Repeated analysis of cinephotographic and cinefluorographic studies, correlated with clinical observations, has helped elucidate the causes of contact ulcers. Habitual throat clearing, excessive glottic attack in initiation of speech, and, most important, acid regurgitation secondary to hiatal hernia are the causal factors of contact ulcers. Contact granulomas produced by intubation trauma and other granulomas are compared and discussed. The successful treatment of contact ulcers and granulomas is dependent on elimination of vocal abuse, cessation of throat clearing, and control of the factors that cause the irritation and throat clearing.- - - - - - - - - - ranking = 1.5keywords = throat (Clic here for more details about this article) |
10/12. Case report of and description of parasite in Mammomonogamus laryngeus (human syngamosis) infection.About 100 cases of human infections with Mammomonogamus laryngeus (Syngamidae, Syngaminae) have been reported, with virtually all cases originating in the Caribbean islands and brazil. This report describes the fifth patient in north america infected with M. laryngeus and the first case documented to originate in jamaica. The patient complained of a characteristic persistent nonproductive cough and a lump in her throat. M. laryngeus is a nematode in which the male and female are permanently joined in copula, producing a distinctive Y shape. Since there is scant clinical information about this parasite, this report includes a description of the adult worms and eggs, a summary of the epidemiology, and the clinical manifestations in humans. Illustrations are presented to facilitate future identification of this parasite and to expedite treatment.- - - - - - - - - - ranking = 0.5keywords = throat (Clic here for more details about this article) |
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