3. Infekcioza mononukleoze
Synonyms: 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.
5. TBC
Oral 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. Difterija
The 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.
8. Šarlaks
The 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.
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.
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11. Herpangīna
Herpangina 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 adults
Herpangina typically has an incubation period of 4-14 days
Bilateral, anterior, cervical lymphadenopathy may
occur, resulting from infection of the posterior
oropharynx.
