Uvulitis

General

  • Uvulitis is characterized by inflammation and edema of uvula
  • Isolated uvular inflammation is rare
  • More commonly manifests with other inflammatory diseases of oropharynx:
  • Rarely causes life threatening respiratory distress

Etiologies

Clinical Features

History

  • Throat pain
  • Dysphagia, sensation of something in their throat, gagging sensation
  • Low-grade fever
  • Signs/symptoms of concomitant epiglottitis
  • +/- Features indicative of etiology:
    • Sick contacts
    • Allergen exposure
    • Recent surgical procedure with site of entry via mouth (EGD, laryngoscopy, OGT, etc)
    • Recent inhalation of cannabis
    • Incomplete vaccination status
      • H. Influenzae - epiglottis
      • First H. Influenzae vaccine at 2 months, last booster 12-15 months
    • Hereditary angioedema

Physical Exam

  • General
    • Range from well appearing to toxic
  • Uvula
    • Markedly erythematous and edematous
    • Pinpoint hemorrhage is possible
    • Vesicular lesions possible if viral etiology
    • Nonerythematous, pale, swollen (uvular hydrops) may indicate angioedema
  • Tonsils
    • Edematous vs. nonedematous
    • Exudative vs. nonexudative
  • Erythematous posterior pharynx
  • Respiratory

Differential Diagnosis

Evaluation

  • Rapid strep throat swab
  • Heterophile antibody (monospot) test
  • If patient is ill appearing consider:
    • CBC
    • CMP
    • Blood culture
  • Imaging
    • If concern for epiglottitis
      • Lateral neck x-ray
    • If concern for retropharyngeal abscess
      • CT neck with contrast

Management

Infectious

Epiglottitis

Streptococcal Pharyngitis

  • Pediatrics
    • Penicillin V 250mg PO BID x 10 days
    • Amoxicillin 50mg/kg PO once daily x 10 days
  • Adults
    • Penicillin V 500mg PO BID x 10 days
    • If compliance is unlikely
      • Benzathine Penicillin 25,000Units/kg IM (to a maximum of 1.2 million units) x 1 dose
    • If allergic to PCN

C. Albicans

Noninfectious

Trauma

Allergic Reaction

Angioedema

Inhalant irritation

Disposition

  • Determined by severity, complications, etc.

See Also

External Links

References