Differentials
Tonsillitis
SIGNS / SYMPTOMS
There may be no significant difference in signs and symptoms, but hoarseness is more pronounced in laryngitis.
INVESTIGATIONS
Indirect laryngoscopy will not show erythema and edema of the laryngeal structures in acute tonsillitis.
Infectious mononucleosis
SIGNS / SYMPTOMS
Hepatomegaly and splenomegaly usually present.
Rash and generalized fatigue may occur.
Exudates are creamy in color and usually do not extend beyond the tonsils.
There is no bleeding when the exudates are removed.
INVESTIGATIONS
Positive heterophile antibody test or positive serology test.
Allergic rhinitis
SIGNS / SYMPTOMS
No sign or symptom of an acute infection.
Other allergy-related history or symptoms (e.g., sneezing, nasal pruritus, and allergic conjunctivitis) are present.
INVESTIGATIONS
Improvement with a therapeutic trial of antihistamines or intranasal corticosteroid medication.
Allergy skin prick testing or in vitro-specific IgE determination may detect allergic response to a specific allergen.
Laryngeal carcinoma
SIGNS / SYMPTOMS
There may be no difference in signs and symptoms between laryngeal cancer and tuberculous laryngitis.
INVESTIGATIONS
A direct laryngoscopy should be performed and biopsies obtained.
Biopsy will demonstrate malignancy in patients with laryngeal carcinoma, whereas biopsy may show granulomatous necrosis and acid-fast bacilli in patients with tuberculosis infection.
GERD
SIGNS / SYMPTOMS
Presenting symptoms commonly include heartburn and acid regurgitation.
INVESTIGATIONS
Esophagogastroduodenoscopy (EGD) may show esophagitis (erosion, ulcerations, strictures) or Barrett esophagus.
Patients may respond to a therapeutic trial of a proton pump inhibitor.
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