Adenoiditis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

Overview

Patients with adenoiditis are usually good-appearing. Physical examination of patients with adenoiditis is usually remarkable for fever, and purulent nasal discharges.^[1]^[2]^[3]

Physical exam

Appearance of the Patient

Patient is usually good-appearing in early stages, but may be ill appearing if the complications and disease severity are present.

Vital Signs

Fever
Tachycardia can be present as a result of infection or pneumonia
Tachypnea can be present as a result of infection or pneumonia

HEENT

Otoscopic examination of the ears may reveal the following signs indicative of concurrent otitis media:^[4]
- Erythema of the middle ear
- Presence of purulent effusion^[5]
- Bulging of the tympanic membrane in otitis media with effusion
- Cloudy appearance of the tympanic membrane
- Immobility of the tympanic membrane
- Tympanic membrane perforation
Purulent exudate from nose can be present as a result of concurrent sinusitis
Facial and maxillary tenderness can be present as a result of concurrent sinusitis or the acute adenoiditis itself
Erythematous throat with tonsillar swelling, exudates, and/or petechiae
Oral mucous may be dry with ulcers due to mouth breathing

Neck

Lymphadenopathy of cervical nodes

Lungs

Fine crackles upon auscultation of the lung due to concurrent pneumonia

References

↑ Kosikowska U, Korona-Głowniak I, Niedzielski A, Malm A (2015). “Nasopharyngeal and Adenoid Colonization by Haemophilus influenzae and Haemophilus parainfluenzae in Children Undergoing Adenoidectomy and the Ability of Bacterial Isolates to Biofilm Production”. Medicine (Baltimore). 94 (18): e799. doi:10.1097/MD.0000000000000799. PMC 4602522. PMID 25950686.
↑ Kajan ZD, Sigaroudi AK, Mohebbi M (2016). “Prevalence and patterns of palatine and adenoid tonsilloliths in cone-beam computed tomography images of an Iranian population”. Dent Res J (Isfahan). 13 (4): 315–21. PMC 4993058. PMID 27605988.
↑ Galli J, Calò L, Ardito F, Imperiali M, Bassotti E, Fadda G, Paludetti G (2007). “Biofilm formation by Haemophilus influenzae isolated from adeno-tonsil tissue samples, and its role in recurrent adenotonsillitis”. Acta Otorhinolaryngol Ital. 27 (3): 134–8. PMC 2640046. PMID 17883191.
↑ Rettig E, Tunkel DE (2014). “Contemporary concepts in management of acute otitis media in children”. Otolaryngol. Clin. North Am. 47 (5): 651–72. doi:10.1016/j.otc.2014.06.006. PMC 4393005. PMID 25213276.
↑ Parlea E, Georgescu M, Calarasu R (2012). “Tympanometry as a predictor factor in the evolution of otitis media with effusion”. J Med Life. 5 (4): 452–4. PMC 3539835. PMID 23346249.

[pmid25950686-1] Kosikowska U, Korona-Głowniak I, Niedzielski A, Malm A (2015). “Nasopharyngeal and Adenoid Colonization by Haemophilus influenzae and Haemophilus parainfluenzae in Children Undergoing Adenoidectomy and the Ability of Bacterial Isolates to Biofilm Production”. Medicine (Baltimore). 94 (18): e799. doi:10.1097/MD.0000000000000799. PMC 4602522. PMID 25950686.

[pmid27605988-2] Kajan ZD, Sigaroudi AK, Mohebbi M (2016). “Prevalence and patterns of palatine and adenoid tonsilloliths in cone-beam computed tomography images of an Iranian population”. Dent Res J (Isfahan). 13 (4): 315–21. PMC 4993058. PMID 27605988.

[pmid17883191-3] Galli J, Calò L, Ardito F, Imperiali M, Bassotti E, Fadda G, Paludetti G (2007). “Biofilm formation by Haemophilus influenzae isolated from adeno-tonsil tissue samples, and its role in recurrent adenotonsillitis”. Acta Otorhinolaryngol Ital. 27 (3): 134–8. PMC 2640046. PMID 17883191.

[pmid25213276-4] Rettig E, Tunkel DE (2014). “Contemporary concepts in management of acute otitis media in children”. Otolaryngol. Clin. North Am. 47 (5): 651–72. doi:10.1016/j.otc.2014.06.006. PMC 4393005. PMID 25213276.

[pmid23346249-5] Parlea E, Georgescu M, Calarasu R (2012). “Tympanometry as a predictor factor in the evolution of otitis media with effusion”. J Med Life. 5 (4): 452–4. PMC 3539835. PMID 23346249.

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